KATHERYNE TIFUH AMBA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****20

License Status

NOT RENEWED

Business

First Name

KATHERYNE

Middle

TIFUH

Last Name

AMBA

Business Name

KATHERYNE TIFUH AMBA

Original Issue Date

09/22/2014

Effective Date

04/10/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60637

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021