SAMANTHA L CERQUA 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

SAMANTHA

Middle

Last Name

CERQUA

Business Name

SAMANTHA L CERQUA

Original Issue Date

10/22/2020

Effective Date

10/22/2020

Expiration Date

08/31/2022

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022