CHARLES BAHATI SEBUNYENZI Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****91

License Status

INACTIVE

Business

First Name

CHARLES

Middle

BAHATI

Last Name

SEBUNYENZI

Business Name

CHARLES BAHATI SEBUNYENZI

Original Issue Date

04/30/2021

Effective Date

04/30/2021

Expiration Date

08/31/2022

City

GRANITE CITY

State

Zip

62040

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2022