MALLORY MARIE BOLANDER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****71

License Status

ACTIVE

Business

First Name

MALLORY

Middle

MARIE

Last Name

BOLANDER

Business Name

MALLORY MARIE BOLANDER

Original Issue Date

06/09/2025

Effective Date

06/09/2025

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026