MALLORY A SIMONTON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****10

License Status

ACTIVE

Business

First Name

MALLORY

Middle

Last Name

SIMONTON

Business Name

MALLORY A SIMONTON

Original Issue Date

12/04/2018

Effective Date

04/25/2024

Expiration Date

05/31/2026

City

PARIS

State

Zip

61944

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026