ABIGAIL D LAKE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****98

License Status

ACTIVE

Business

First Name

ABIGAIL

Middle

Last Name

LAKE

Business Name

ABIGAIL D LAKE

Original Issue Date

11/20/2023

Effective Date

03/20/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026