CARRIE KALLAL Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****59

License Status

ACTIVE

Business

First Name

CARRIE

Last Name

KALLAL

Business Name

CARRIE KALLAL

Original Issue Date

10/08/2020

Effective Date

03/12/2026

Expiration Date

05/31/2028

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/12/2026