JARED BANASZAK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****01

License Status

ACTIVE

Business

First Name

JARED

Last Name

BANASZAK

Business Name

JARED BANASZAK

Original Issue Date

12/09/2021

Effective Date

06/24/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60647

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026