BETH A KILLAM Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****98

License Status

INACTIVE

Business

First Name

BETH

Middle

Last Name

KILLAM

Business Name

BETH A KILLAM

Original Issue Date

11/13/2001

Effective Date

05/16/2022

Expiration Date

05/31/2024

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2022