KELLIE ELIZABETH BIBB Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****78

License Status

INACTIVE

Business

First Name

KELLIE

Middle

ELIZABETH

Last Name

BIBB

Business Name

KELLIE ELIZABETH BIBB

Original Issue Date

02/07/2017

Effective Date

04/12/2018

Expiration Date

09/30/2020

City

CHATHAM

State

Zip

62629

County

SANGAMON

Delegated Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

04/11/2018