AMANDA J BORMANN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****63

License Status

ACTIVE

Business

First Name

AMANDA

Middle

Last Name

BORMANN

Business Name

AMANDA J BORMANN

Original Issue Date

09/03/2024

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026