KRISTINE MARIE COSTELLO Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****72

License Status

INACTIVE

Business

First Name

KRISTINE

Middle

MARIE

Last Name

COSTELLO

Business Name

KRISTINE MARIE COSTELLO

Original Issue Date

05/06/2016

Effective Date

04/15/2024

Expiration Date

05/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/26/2024