Person Information

Name:JENNIFER LYNN WILSON CAMPOLONG

Address Information

Address(city state zipcode):Clearfield PA16830

License Information

Type:Prescriptive AuthoritySecondary Type:Number:005306
Profession:NursingStatus:Agreement Terminated
Issue Date:6/21/2006Expires:4/30/2014Last Renewed:4/17/2012

Prerequisite Information

Licensee:CAMPOLONG, JENNIFER LYNN WILSONRelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:SP007523Status:Active
Date of Association:Date of Expiration:

Licensee:ELKINS, CAROL GAYRelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD036923EStatus:Active
Date of Association:6/21/2006Date of Expiration:5/10/2012

License CSR Information

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

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