SHAMBRA C CULLUM Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****82

License Status

NOT RENEWED

Business

First Name

SHAMBRA

Middle

Last Name

CULLUM

Business Name

SHAMBRA C CULLUM

Original Issue Date

08/29/2018

Effective Date

08/29/2018

Expiration Date

09/30/2020

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021