KELSIE MARIE MENTZ Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****92

License Status

NOT RENEWED

Business

First Name

KELSIE

Middle

MARIE

Last Name

MENTZ

Business Name

KELSIE MARIE MENTZ

Original Issue Date

02/08/2017

Effective Date

03/20/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61636

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021