MARILOU A JOHNSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****66

License Status

NOT RENEWED

Business

First Name

MARILOU A

Last Name

JOHNSON

Business Name

MARILOU A JOHNSON

Original Issue Date

07/27/2001

Effective Date

05/18/2022

Expiration Date

06/30/2024

City

KEWANEE

State

Zip

61443

County

HENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025