KILEY M FAIRES 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

KILEY

Middle

Last Name

FAIRES

Business Name

KILEY M FAIRES

Original Issue Date

06/10/2016

Effective Date

05/01/2024

Expiration Date

05/31/2026

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026