KELLY E ELLIS Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****50

License Status

ACTIVE

Business

First Name

KELLY

Middle

Last Name

ELLIS

Business Name

KELLY E ELLIS

Original Issue Date

11/30/2010

Effective Date

05/04/2024

Expiration Date

05/31/2026

City

BERWYN

State

Zip

60402

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026