MILENA TRACI MASK 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

MILENA

Middle

TRACI

Last Name

MASK

Business Name

MILENA TRACI MASK

Original Issue Date

07/17/2019

Effective Date

08/28/2022

Expiration Date

06/30/2024

City

MOKENA

State

Zip

60448

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025