ALLYSON KIMBLEY GOUGH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****30

License Status

ACTIVE

Business

First Name

ALLYSON

Middle

KIMBLEY

Last Name

GOUGH

Business Name

ALLYSON KIMBLEY GOUGH

Original Issue Date

02/14/2003

Effective Date

05/24/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026