AGNIESZKA M BERTUCCI Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

NOT RENEWED

Business

First Name

AGNIESZKA

Middle

Last Name

BERTUCCI

Business Name

AGNIESZKA M BERTUCCI

Original Issue Date

03/21/2023

Effective Date

03/21/2023

Expiration Date

06/30/2024

City

WILLOWBROOK

State

Zip

60527

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025