KELLY M SIDOR Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

SIDOR

Business Name

KELLY M SIDOR

Original Issue Date

09/07/2011

Effective Date

08/06/2020

Expiration Date

08/31/2022

City

CHICAGO

State

Zip

60647

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022