STEPHANIE L BERTRAM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****83

License Status

ACTIVE

Business

First Name

STEPHANIE

Middle

Last Name

BERTRAM

Business Name

STEPHANIE L BERTRAM

Original Issue Date

10/01/2018

Effective Date

05/03/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026