ALICIA SULLIVAN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****22

License Status

NOT RENEWED

Business

First Name

ALICIA

Last Name

SULLIVAN

Business Name

ALICIA SULLIVAN

Original Issue Date

08/11/2021

Effective Date

08/11/2021

Expiration Date

08/31/2022

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/14/2022