AMANDA M PEREGRIN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****64

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

PEREGRIN

Business Name

AMANDA M PEREGRIN

Original Issue Date

02/02/2015

Effective Date

06/18/2022

Expiration Date

06/30/2024

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025