MARIAH N HOLLOWAY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****65

License Status

ACTIVE

Business

First Name

MARIAH

Middle

Last Name

HOLLOWAY

Business Name

MARIAH N HOLLOWAY

Original Issue Date

01/25/2022

Effective Date

06/12/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

03/02/2026