KELLY P LOPEZ Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****04

License Status

ACTIVE

Business

First Name

KELLY

Middle

Last Name

LOPEZ

Business Name

KELLY P LOPEZ

Original Issue Date

12/27/2019

Effective Date

04/18/2024

Expiration Date

05/31/2026

City

DEKALB

State

Zip

60115

County

DEKALB

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026