AMANDA D BENNETT Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****63

License Status

INACTIVE

Business

First Name

AMANDA D

Last Name

BENNETT

Business Name

AMANDA D BENNETT

Original Issue Date

10/07/2010

Effective Date

04/22/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/20/2018