SHAMMONA SHALISA CLARK Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****14

License Status

INACTIVE

Business

First Name

SHAMMONA

Middle

SHALISA

Last Name

CLARK

Business Name

SHAMMONA SHALISA CLARK

Original Issue Date

09/26/2019

Effective Date

03/08/2020

Expiration Date

05/31/2022

City

CHICAGO

State

Zip

60616

Ever Disciplined

LastModifiedDate

09/18/2020