KELLY TAIS AZAMBUJA CACHOEIRA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****02

License Status

ACTIVE

Business

First Name

KELLY TAIS

Last Name

AZAMBUJA CACHOEIRA

Business Name

KELLY TAIS AZAMBUJA CACHOEIRA

Original Issue Date

03/07/2024

Effective Date

03/07/2024

Expiration Date

05/31/2026

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/06/2024