COLLEEN MARTIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****86

License Status

ACTIVE

Business

First Name

COLLEEN

Last Name

MARTIN

Business Name

COLLEEN MARTIN

Original Issue Date

07/24/2024

Effective Date

07/24/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61114

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026