KRISTA PUCKETT Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

ACTIVE

Business

First Name

KRISTA

Last Name

PUCKETT

Business Name

KRISTA PUCKETT

Original Issue Date

10/16/2018

Effective Date

05/14/2024

Expiration Date

05/31/2026

City

VILLA PARK

State

Zip

60181

County

COOK

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026