SANDRA DEBAULT FREY 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

SANDRA

Middle

DEBAULT

Last Name

FREY

Business Name

SANDRA DEBAULT FREY

Original Issue Date

12/23/2022

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2026