JUDITH MARIE BANNING Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****72

License Status

INACTIVE

Business

First Name

JUDITH

Middle

MARIE

Last Name

BANNING

Business Name

JUDITH MARIE BANNING

Original Issue Date

06/19/2001

Effective Date

09/28/2020

Expiration Date

08/31/2022

City

DECATUR

State

Zip

62521

County

MONTGOMERY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/17/2022