MUNIB S MAFAZY Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****03

License Status

INACTIVE

Business

First Name

MUNIB

Middle

Last Name

MAFAZY

Business Name

MUNIB S MAFAZY

Original Issue Date

10/24/2007

Effective Date

04/12/2018

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

03/08/2020