ALISSA D SMITH Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****29

License Status

NOT RENEWED

Business

First Name

ALISSA

Middle

Last Name

SMITH

Business Name

ALISSA D SMITH

Original Issue Date

04/28/2017

Effective Date

05/29/2018

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021