LISA DAWN RUSSELL Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****25

License Status

NOT RENEWED

Business

First Name

LISA

Middle

DAWN

Last Name

RUSSELL

Business Name

LISA DAWN RUSSELL

Original Issue Date

04/15/2019

Effective Date

04/15/2019

Expiration Date

09/30/2020

City

DAHLGREN

State

Zip

62828

County

HAMILTON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021