KALLIE A SMITH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****32

License Status

ACTIVE

Business

First Name

KALLIE

Middle

Last Name

SMITH

Business Name

KALLIE A SMITH

Original Issue Date

06/26/2025

Effective Date

06/26/2025

Expiration Date

05/31/2026

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026