KELLY MARIE JOHNSON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****03

License Status

ACTIVE

Business

First Name

KELLY

Middle

MARIE

Last Name

JOHNSON

Business Name

KELLY MARIE JOHNSON

Original Issue Date

10/05/2018

Effective Date

03/06/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026