TRACY ANN IVERSEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****96

License Status

ACTIVE

Business

First Name

TRACY

Middle

ANN

Last Name

IVERSEN

Business Name

TRACY ANN IVERSEN

Original Issue Date

09/14/2024

Effective Date

09/14/2024

Expiration Date

05/31/2026

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026