ASHLIE LYNNE LONG Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****77

License Status

INACTIVE

Business

First Name

ASHLIE

Middle

LYNNE

Last Name

LONG

Business Name

ASHLIE LYNNE LONG

Original Issue Date

05/09/2016

Effective Date

04/11/2018

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2018