CARLY ANNE ELLISON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****49

License Status

NOT RENEWED

Business

First Name

CARLY

Middle

ANNE

Last Name

ELLISON

Business Name

CARLY ANNE ELLISON

Original Issue Date

06/22/2015

Effective Date

08/17/2022

Expiration Date

06/30/2024

City

GLENARM

State

Zip

62536

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025