EMILY ROSE KIST Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

ACTIVE

Business

First Name

EMILY

Middle

ROSE

Last Name

KIST

Business Name

EMILY ROSE KIST

Original Issue Date

06/04/2024

Effective Date

06/04/2024

Expiration Date

05/31/2026

City

PALM SPRINGS

State

Zip

33406

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026