Person Information

Name:EILEEN POLT CARPENTER

Address Information

Address(city state zipcode):KENNETT SQUARE PA19348

License Information

Type:Prescriptive AuthoritySecondary Type:Number:005661
Profession:NursingStatus:Active
Issue Date:10/13/2006Expires:4/30/2016Last Renewed:3/25/2014

Prerequisite Information

Licensee:CARPENTER, EILEEN POLTRelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:SP002251GStatus:Active
Date of Association:Date of Expiration:

Licensee:KRELL, STEPHEN PAULRelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD022996EStatus:Active
Date of Association:10/13/2006Date of Expiration:

License CSR Information

Drug Schedule 2:YDrug Schedule 3:YDrug Schedule 4:YDrug Schedule 5:

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