ANNIE D IMBODEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****68

License Status

ACTIVE

Business

First Name

ANNIE

Middle

Last Name

IMBODEN

Business Name

ANNIE D IMBODEN

Original Issue Date

10/10/2007

Effective Date

05/20/2024

Expiration Date

05/31/2026

City

MARION

State

Zip

62959

County

WILLIAMSON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026