MUBANGU M MANDAMUNA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****95

License Status

ACTIVE

Business

First Name

MUBANGU

Middle

Last Name

MANDAMUNA

Business Name

MUBANGU M MANDAMUNA

Original Issue Date

02/01/2022

Effective Date

05/01/2024

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026