LORI L ELLIS Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****69

License Status

INACTIVE

Business

First Name

LORI

Middle

Last Name

ELLIS

Business Name

LORI L ELLIS

Original Issue Date

01/19/2017

Effective Date

09/01/2020

Expiration Date

05/31/2022

City

MORRIS

State

Zip

60450

County

GRUNDY

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/01/2020