GRANT ERICH BERQUIST Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

ACTIVE

Business

First Name

GRANT

Middle

ERICH

Last Name

BERQUIST

Business Name

GRANT ERICH BERQUIST

Original Issue Date

04/19/2023

Effective Date

05/09/2024

Expiration Date

05/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026