MICHAEL A WITHALL Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****73

License Status

ACTIVE

Business

First Name

MICHAEL A

Last Name

WITHALL

Business Name

MICHAEL A WITHALL

Original Issue Date

01/19/2017

Effective Date

05/27/2024

Expiration Date

05/31/2026

City

SUGAR GROVE

State

Zip

60554

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026