KELLIE FRISSORA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****28

License Status

ACTIVE

Business

First Name

KELLIE

Last Name

FRISSORA

Business Name

KELLIE FRISSORA

BusinessDBA

LODGE

Original Issue Date

07/08/2020

Effective Date

05/28/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026