KENNETH P EVANGELISTA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209010652

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

Last Name

EVANGELISTA

Business Name

KENNETH P EVANGELISTA

Original Issue Date

08/16/2013

Effective Date

09/23/2020

Expiration Date

08/31/2022

City

SAN DIEGO

State

Zip

92110

County

COOK

Ever Disciplined

LastModifiedDate

10/14/2022