IDA M DIXON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****04

License Status

NOT RENEWED

Business

First Name

IDA M

Last Name

DIXON

Business Name

IDA M DIXON

Original Issue Date

08/22/2012

Effective Date

04/09/2020

Expiration Date

08/31/2022

City

CHICAGO

State

Zip

60653

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022