KELLY SUE MIXON Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

INOPERATIVE

Business

First Name

KELLY

Middle

SUE

Last Name

MIXON

Business Name

KELLY SUE MIXON

Original Issue Date

06/28/2016

Effective Date

04/16/2024

Expiration Date

05/31/2026

City

QUINCY

State

Zip

62301

County

KNOX

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2024