BROOKE N MACDOUGALL Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****78

License Status

INACTIVE

Business

First Name

BROOKE

Middle

Last Name

MACDOUGALL

Business Name

BROOKE N MACDOUGALL

Original Issue Date

09/20/2019

Effective Date

03/12/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/21/2025