KELLY K FORSTER IVY Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****68

License Status

INACTIVE

Business

First Name

KELLY

Middle

Last Name

FORSTER IVY

Business Name

KELLY K FORSTER IVY

Original Issue Date

01/07/2013

Effective Date

06/23/2020

Expiration Date

05/31/2022

City

CARY

State

Zip

60013

County

MCHENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2020