NIKITA S GUMMADI Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****07

License Status

ACTIVE

Business

First Name

NIKITA

Middle

Last Name

GUMMADI

Business Name

NIKITA S GUMMADI

Original Issue Date

07/08/2019

Effective Date

04/20/2024

Expiration Date

05/31/2026

City

FLOSSMOOR

State

Zip

60422

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026