DAMARIS J PERALTA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****19

License Status

NOT RENEWED

Business

First Name

DAMARIS

Middle

Last Name

PERALTA

Business Name

DAMARIS J PERALTA

Original Issue Date

02/14/2017

Effective Date

04/23/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60623

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021