Person Information

Name:LISA SHANE DUSCH

Address Information

Address(city state zipcode):ALIQUIPPA PA15001

License Information

Type:Prescriptive AuthoritySecondary Type:Number:005247
Profession:NursingStatus:Agreement Terminated
Issue Date:6/7/2006Expires:10/31/2007Last Renewed:

Prerequisite Information

Licensee:DUSCH, LISA SHANERelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:VP005059BStatus:Active
Date of Association:Date of Expiration:

Licensee:GOLTZ, GERALD MARVINRelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD015354EStatus:Active
Date of Association:6/7/2006Date of Expiration:4/6/2007

License CSR Information

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

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