AMANDA K LONG Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****63

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

LONG

Business Name

AMANDA K LONG

Original Issue Date

06/17/2020

Effective Date

06/17/2020

Expiration Date

08/31/2022

City

CHESTER

State

Zip

62233

County

RANDOLPH

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022