MARY E NOVOTNY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****97

License Status

ACTIVE

Business

First Name

MARY

Middle

Last Name

NOVOTNY

Business Name

MARY E NOVOTNY

Original Issue Date

09/16/2015

Effective Date

05/03/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026