MARY A HOLEM 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

MARY A

Last Name

HOLEM

Business Name

MARY A HOLEM

Original Issue Date

01/27/2016

Effective Date

04/11/2018

Expiration Date

09/30/2020

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021