ANGELA M LONGEVILLE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****61

License Status

ACTIVE

Business

First Name

ANGELA

Middle

Last Name

LONGEVILLE

Business Name

ANGELA M LONGEVILLE

Original Issue Date

12/18/2018

Effective Date

05/07/2024

Expiration Date

05/31/2026

City

PERU

State

Zip

61354

County

LA SALLE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026