MALLORY R WITTIG Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****84

License Status

ACTIVE

Business

First Name

MALLORY

Middle

Last Name

WITTIG

Business Name

MALLORY R WITTIG

Original Issue Date

03/26/2012

Effective Date

04/12/2024

Expiration Date

05/31/2026

City

METROPOLIS

State

Zip

62960

County

MASSAC

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026