MELISSA K JOHNSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****77

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

Last Name

JOHNSON

Business Name

MELISSA K JOHNSON

Original Issue Date

02/07/2017

Effective Date

03/13/2018

Expiration Date

09/30/2020

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021