Person Information

Name:MONICA DISSLER MCCULLOUGH

Address Information

Address(city state zipcode):CHALFONT PA18914

License Information

Type:Prescriptive AuthoritySecondary Type:Number:005525
Profession:NursingStatus:Expired
Issue Date:9/13/2006Expires:10/31/2008Last Renewed:

Prerequisite Information

Licensee:BAUMGAERTEL, ANNA HELENERelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD418641Status:Active
Date of Association:9/13/2006Date of Expiration:

Licensee:MCCULLOUGH, MONICA DISSLERRelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:TP004475DStatus:Active
Date of Association:Date of Expiration:

License CSR Information

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

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