LAURA A HICKENBOTTOM 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

LAURA

Middle

Last Name

HICKENBOTTOM

Business Name

LAURA A HICKENBOTTOM

Original Issue Date

08/03/2018

Effective Date

05/28/2024

Expiration Date

05/31/2026

City

URBANA

State

Zip

61801

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026