DIETRA L ANGELLY Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****82

License Status

INACTIVE

Business

First Name

DIETRA L

Last Name

ANGELLY

Business Name

DIETRA L ANGELLY

Original Issue Date

03/23/2019

Effective Date

05/20/2022

Expiration Date

05/31/2024

City

HARRISBURG

State

Zip

62946

County

SALINE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/31/2023