Person Information

Name:LISA M DEDOMENICO

Address Information

Address(city state zipcode):Larksville PA18704

License Information

Type:Prescriptive AuthoritySecondary Type:Number:006437
Profession:NursingStatus:Agreement Terminated
Issue Date:5/14/2007Expires:10/31/2008Last Renewed:

Prerequisite Information

Licensee:DEDOMENICO, LISA MRelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:TP001029GStatus:Active
Date of Association:Date of Expiration:

Licensee:WOLF, ABIGAILRelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD066936LStatus:Active
Date of Association:5/14/2007Date of Expiration:11/1/2007

License CSR Information

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

Comments


search At least 3 letters.