TATUM J REYNOLDS 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

TATUM

Middle

Last Name

REYNOLDS

Business Name

TATUM J REYNOLDS

Original Issue Date

08/20/2020

Effective Date

03/10/2024

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026