KELLY D STOUT Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****20

License Status

ACTIVE

Business

First Name

KELLY

Middle

Last Name

STOUT

Business Name

KELLY D STOUT

Original Issue Date

03/08/2026

Effective Date

03/08/2026

Expiration Date

05/31/2028

City

MOKENA

State

Zip

60448

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/08/2026