TAYLOR MARLENE JOHNSON 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

TAYLOR

Middle

MARLENE

Last Name

JOHNSON

Business Name

TAYLOR MARLENE JOHNSON

Original Issue Date

12/13/2024

Effective Date

12/13/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026