KRISTIN ANN GREEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****00

License Status

ACTIVE

Business

First Name

KRISTIN

Middle

ANN

Last Name

GREEN

Business Name

KRISTIN ANN GREEN

Original Issue Date

11/04/2021

Effective Date

05/16/2025

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61615

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026