AGNIESZKA S BASTA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209016452

License Status

ACTIVE

Business

First Name

AGNIESZKA

Middle

Last Name

BASTA

Business Name

AGNIESZKA S BASTA

Original Issue Date

08/28/2017

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

LAKE BARRINGTON

State

Zip

60010

County

LAKE

Ever Disciplined

LastModifiedDate

03/04/2026