MICHAEL RYAN MANDRELL Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****75

License Status

INACTIVE

Business

First Name

MICHAEL

Middle

RYAN

Last Name

MANDRELL

Business Name

MICHAEL RYAN MANDRELL

Original Issue Date

02/16/2019

Effective Date

03/30/2020

Expiration Date

05/31/2022

City

PEORIA

State

Zip

61606

County

PEORIA

Ever Disciplined

LastModifiedDate

03/30/2020