SUSAN COLLAZO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****16

License Status

NOT RENEWED

Business

First Name

SUSAN

Last Name

COLLAZO

Business Name

SUSAN COLLAZO

Original Issue Date

08/29/2001

Effective Date

03/22/2018

Expiration Date

09/30/2020

City

BARTLETT

State

Zip

60103

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021