KELLI M FULLER Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****43

License Status

INOPERATIVE

Business

First Name

KELLI

Middle

Last Name

FULLER

Business Name

KELLI M FULLER

Original Issue Date

08/10/2001

Effective Date

08/10/2001

Expiration Date

05/31/2004

City

MADISON

State

Zip

62060

County

MADISON

Ever Disciplined

LastModifiedDate

09/28/2006