SAMANTHA MARTIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****77

License Status

ACTIVE

Business

First Name

SAMANTHA

Last Name

MARTIN

Business Name

SAMANTHA MARTIN

Original Issue Date

07/28/2021

Effective Date

05/16/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026