KELLIE LUSTENBERGER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****58

License Status

ACTIVE

Business

First Name

KELLIE

Last Name

LUSTENBERGER

Business Name

KELLIE LUSTENBERGER

Original Issue Date

09/27/2007

Effective Date

03/13/2026

Expiration Date

05/31/2028

City

HERRIN

State

Zip

62948

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/13/2026