ALEX GREGORY NIEBRUGGE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****66

License Status

ACTIVE

Business

First Name

ALEX

Middle

GREGORY

Last Name

NIEBRUGGE

Business Name

ALEX GREGORY NIEBRUGGE

Original Issue Date

10/05/2022

Effective Date

04/26/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026