MELISSA JANE STROM Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****30

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

JANE

Last Name

STROM

Business Name

MELISSA JANE STROM

Original Issue Date

10/28/2015

Effective Date

05/14/2018

Expiration Date

09/30/2020

City

LA SALLE

State

Zip

61301

County

LA SALLE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021