MARY L BROOKS 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

MARY

Middle

Last Name

BROOKS

Business Name

MARY L BROOKS

Original Issue Date

09/12/2018

Effective Date

09/12/2018

Expiration Date

09/30/2020

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021