JULIE WAGNER 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

JULIE

Last Name

WAGNER

Business Name

JULIE WAGNER

Original Issue Date

03/08/2023

Effective Date

04/22/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026