TIBESSA TIFFANY LAWRENCE ELLIS Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****02

License Status

INACTIVE

Business

First Name

TIBESSA

Middle

TIFFANY

Last Name

LAWRENCE ELLIS

Business Name

TIBESSA TIFFANY LAWRENCE ELLIS

Original Issue Date

01/16/2015

Effective Date

05/10/2022

Expiration Date

05/31/2024

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2024