JOHN MARC PROVENZANO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209001255

License Status

NOT RENEWED

Business

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

City

DARIEN

State

Zip

60561

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/14/2021