LARISSA CHAIDEZ 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

LARISSA

Last Name

CHAIDEZ

Business Name

LARISSA CHAIDEZ

Original Issue Date

02/03/2026

Effective Date

02/03/2026

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026