MAYRA JEANETTE RANDA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****12

License Status

NOT RENEWED

Business

First Name

MAYRA

Middle

JEANETTE

Last Name

RANDA

Business Name

MAYRA JEANETTE RANDA

Original Issue Date

08/01/2016

Effective Date

09/24/2020

Expiration Date

08/31/2022

City

CHICAGO

State

Zip

60660

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022