KELSEY M LISIUS-BLAMOUN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****96

License Status

ACTIVE

Business

First Name

KELSEY

Middle

Last Name

LISIUS-BLAMOUN

Business Name

KELSEY M LISIUS-BLAMOUN

Original Issue Date

09/24/2019

Effective Date

03/03/2024

Expiration Date

05/31/2026

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026