JESSE LEE HENNEBERG Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****69

License Status

ACTIVE

Business

First Name

JESSE

Middle

LEE

Last Name

HENNEBERG

Business Name

JESSE LEE HENNEBERG

Original Issue Date

07/06/2021

Effective Date

03/25/2024

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026