SUSAN ALICE COLBURN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****91

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

ALICE

Last Name

COLBURN

Business Name

SUSAN ALICE COLBURN

Original Issue Date

02/04/2014

Effective Date

05/15/2018

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63135

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021