JOHN MARC PROVENZANO - Advanced Practice Nurse License in Illinois | # 209001255

JOHN MARC PROVENZANO

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209001255

License Status

NOT RENEWED

Business

N

First Name

JOHN MARC

Last Name

PROVENZANO

Business Name

JOHN MARC PROVENZANO

Original Issue Date

06/20/2001

Effective Date

05/23/2018

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021