NATHAN E KELLENBERGER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****55

License Status

ACTIVE

Business

First Name

NATHAN

Middle

Last Name

KELLENBERGER

Business Name

NATHAN E KELLENBERGER

Original Issue Date

03/08/2023

Effective Date

05/09/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026