SHANNON LEE LUCZAK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****05

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

LEE

Last Name

LUCZAK

Business Name

SHANNON LEE LUCZAK

Original Issue Date

12/04/2013

Effective Date

04/21/2016

Expiration Date

05/31/2018

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

07/19/2018