KELLY K KNACKSTEDT 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

KNACKSTEDT

Business Name

KELLY K KNACKSTEDT

Original Issue Date

08/09/2019

Effective Date

04/03/2024

Expiration Date

05/31/2026

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026