BETHANY K GOTTLIEB Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****87

License Status

ACTIVE

Business

First Name

BETHANY

Middle

Last Name

GOTTLIEB

Business Name

BETHANY K GOTTLIEB

Original Issue Date

12/13/2024

Effective Date

12/13/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61615

Delegated Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

03/02/2026