LISA A FISHBACK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****64

License Status

ACTIVE

Business

First Name

LISA A

Last Name

FISHBACK

Business Name

LISA A FISHBACK

Original Issue Date

09/03/2024

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026