NICOLE I WAGNER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****82

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

WAGNER

Business Name

NICOLE I WAGNER

Original Issue Date

04/03/2009

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

WAUCONDA

State

Zip

60084

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2026