KIMBERLY J BANKSTON Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****25

License Status

INACTIVE

Business

First Name

KIMBERLY

Middle

Last Name

BANKSTON

Business Name

KIMBERLY J BANKSTON

Original Issue Date

04/01/2002

Effective Date

03/19/2018

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/19/2018