KELLY R DAVIS Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****60

License Status

ACTIVE

Business

First Name

KELLY

Middle

Last Name

DAVIS

Business Name

KELLY R DAVIS

Original Issue Date

10/18/2021

Effective Date

04/05/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026