JOSE G MANTILLA-ACEVEDO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****90

License Status

NOT RENEWED

Business

First Name

JOSE

Middle

Last Name

MANTILLA-ACEVEDO

Business Name

JOSE G MANTILLA-ACEVEDO

Original Issue Date

09/02/2010

Effective Date

03/20/2014

Expiration Date

05/31/2016

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/11/2016