AMANDA M WILDERMAN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****74

License Status

INACTIVE

Business

First Name

AMANDA

Middle

Last Name

WILDERMAN

Business Name

AMANDA M WILDERMAN

Original Issue Date

09/09/2021

Effective Date

07/22/2022

Expiration Date

05/31/2024

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

07/22/2022