Person Information

Name:TAMMY L RISTAU

Address Information

Address(city state zipcode):WARREN PA16365

License Information

Type:Prescriptive AuthoritySecondary Type:Number:005574
Profession:NursingStatus:Agreement Terminated
Issue Date:9/22/2006Expires:10/31/2013Last Renewed:10/16/2011

Prerequisite Information

Licensee:KOURTU, MOHAMED ABDILLAHIRelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD049485LStatus:Active
Date of Association:9/22/2006Date of Expiration:6/24/2013

Licensee:RISTAU, TAMMY LRelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:SP008551Status:Active
Date of Association:Date of Expiration:

License CSR Information

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

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