TIMETRA D CLARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****16

License Status

ACTIVE

Business

First Name

TIMETRA

Middle

Last Name

CLARK

Business Name

TIMETRA D CLARK

Original Issue Date

10/15/2022

Effective Date

05/08/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60628

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026