TAMMRA K MALLORY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****48

License Status

ACTIVE

Business

First Name

TAMMRA

Middle

Last Name

MALLORY

Business Name

TAMMRA K MALLORY

Original Issue Date

08/20/2015

Effective Date

04/09/2025

Expiration Date

05/31/2026

City

INDIANAPOLIS

State

Zip

46236

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/21/2025