DAPHNA J SHAW Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****18

License Status

NOT RENEWED

Business

First Name

DAPHNA

Middle

Last Name

SHAW

Business Name

DAPHNA J SHAW

Original Issue Date

12/15/2016

Effective Date

03/13/2018

Expiration Date

09/30/2020

City

PARK RIDGE

State

Zip

60068

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021