MARYANN D EBOM Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****18

License Status

INACTIVE

Business

First Name

MARYANN

Middle

Last Name

EBOM

Business Name

MARYANN D EBOM

Original Issue Date

04/25/2025

Effective Date

04/25/2025

Expiration Date

05/31/2026

City

LANSING

State

Zip

60438

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/15/2025