KIMBERLEY S BURGESS 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

KIMBERLEY

Middle

Last Name

BURGESS

Business Name

KIMBERLEY S BURGESS

Original Issue Date

01/13/2005

Effective Date

01/13/2005

Expiration Date

05/31/2008

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2008