KELLY L PERISIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****85

License Status

ACTIVE

Business

First Name

KELLY

Middle

Last Name

PERISIN

Business Name

KELLY L PERISIN

Original Issue Date

07/08/2021

Effective Date

03/09/2026

Expiration Date

05/31/2028

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

03/09/2026