MATHEW DOUGLAS BLOUNT 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

MATHEW

Middle

DOUGLAS

Last Name

BLOUNT

Business Name

MATHEW DOUGLAS BLOUNT

Original Issue Date

05/30/2024

Effective Date

05/30/2024

Expiration Date

05/31/2026

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026