ANGEL CUSTODIO HERNANDEZ Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

ACTIVE

Business

First Name

ANGEL

Middle

CUSTODIO

Last Name

HERNANDEZ

Business Name

ANGEL CUSTODIO HERNANDEZ

Original Issue Date

12/14/2017

Effective Date

05/09/2024

Expiration Date

05/31/2026

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026