MALLIA EIHENTALE Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****07

License Status

INACTIVE

Business

First Name

MALLIA

Last Name

EIHENTALE

Business Name

MALLIA EIHENTALE

Original Issue Date

06/15/2021

Effective Date

05/13/2024

Expiration Date

05/31/2026

City

ROLLING MEADOWS

State

Zip

60008

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/18/2025