SUSANNAH N DINTZIS 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

SUSANNAH N

Last Name

DINTZIS

Business Name

SUSANNAH N DINTZIS

Original Issue Date

01/29/2007

Effective Date

03/13/2018

Expiration Date

09/30/2020

City

DUNLAP

State

Zip

61525

County

PEORIA

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021