LISA J SUWANAWONGSE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****56

License Status

ACTIVE

Business

First Name

LISA

Middle

Last Name

SUWANAWONGSE

Business Name

LISA J SUWANAWONGSE

Original Issue Date

11/20/2017

Effective Date

03/15/2024

Expiration Date

05/31/2026

City

MARION

State

Zip

62959

County

WILLIAMSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026