MAYCEN E WISEMAN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****85

License Status

ACTIVE

Business

First Name

MAYCEN

Middle

Last Name

WISEMAN

Business Name

MAYCEN E WISEMAN

Original Issue Date

02/19/2021

Effective Date

05/03/2024

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026