KELLIE M O TAKASHIMA Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****10

License Status

INOPERATIVE

Business

First Name

KELLIE

Middle

M O

Last Name

TAKASHIMA

Business Name

KELLIE M O TAKASHIMA

Original Issue Date

03/06/2017

Effective Date

05/29/2020

Expiration Date

05/31/2022

City

CHICAGO

State

Zip

60602

County

COOK

Ever Disciplined

LastModifiedDate

08/30/2022