KELLY J HINES Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

HINES

Business Name

KELLY J HINES

Original Issue Date

11/15/2017

Effective Date

03/11/2018

Expiration Date

09/30/2020

City

MOKENA

State

Zip

60448

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021