JACOB DANIEL WENGERT Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****89

License Status

ACTIVE

Business

First Name

JACOB

Middle

DANIEL

Last Name

WENGERT

Business Name

JACOB DANIEL WENGERT

Original Issue Date

03/23/2021

Effective Date

05/13/2024

Expiration Date

05/31/2026

City

BREESE

State

Zip

62230

County

CLINTON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026