KRISTY D SHAFER Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****93

License Status

INACTIVE

Business

First Name

KRISTY

Middle

Last Name

SHAFER

Business Name

KRISTY D SHAFER

Original Issue Date

01/29/2019

Effective Date

08/23/2022

Expiration Date

05/31/2024

City

DECATUR

State

Zip

62521

County

MACON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/31/2023