KIMBERLY KRISTINE LOPEZ Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****29

License Status

INACTIVE

Business

First Name

KIMBERLY

Middle

KRISTINE

Last Name

LOPEZ

Business Name

KIMBERLY KRISTINE LOPEZ

Original Issue Date

09/14/2016

Effective Date

03/13/2020

Expiration Date

05/31/2022

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/12/2020