THERESA MARIA MEDINA 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

THERESA

Middle

MARIA

Last Name

MEDINA

Business Name

THERESA MARIA MEDINA

Original Issue Date

11/06/2021

Effective Date

08/31/2022

Expiration Date

06/30/2024

City

WAUKEGAN

State

Zip

60085

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025