LISA ANNETTE ELLINGWOOD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

ACTIVE

Business

First Name

LISA

Middle

ANNETTE

Last Name

ELLINGWOOD

Business Name

LISA ANNETTE ELLINGWOOD

Original Issue Date

02/20/2020

Effective Date

04/08/2024

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026