NICHOLE MARIE MACLELLAN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****69

License Status

NOT RENEWED

Business

First Name

NICHOLE

Middle

MARIE

Last Name

MACLELLAN

Business Name

NICHOLE MARIE MACLELLAN

Original Issue Date

04/03/2018

Effective Date

04/03/2018

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021