KELLI JEAN MILLER 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

KELLI

Middle

JEAN

Last Name

MILLER

Business Name

KELLI JEAN MILLER

Original Issue Date

02/22/2017

Effective Date

04/11/2018

Expiration Date

09/30/2020

City

COAL VALLEY

State

Zip

61240

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021