SUSAN KELLER NP 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

Title

First Name

SUSAN

Last Name

KELLER

Business Name

SUSAN KELLER NP

Original Issue Date

06/17/2005

Effective Date

03/14/2018

Expiration Date

09/30/2020

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021