ROMA M SHAH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****05

License Status

ACTIVE

Business

First Name

ROMA

Middle

Last Name

SHAH

Business Name

ROMA M SHAH

Original Issue Date

02/21/2019

Effective Date

03/17/2026

Expiration Date

05/31/2028

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2026