DEIDRA R FONTANA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209004723

License Status

NOT RENEWED

Business

First Name

DEIDRA R

Last Name

FONTANA

Business Name

DEIDRA R FONTANA

Original Issue Date

06/18/2003

Effective Date

03/15/2010

Expiration Date

05/31/2012

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2012