DIANA M FULAZA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****22

License Status

ACTIVE

Business

First Name

DIANA

Middle

Last Name

FULAZA

Business Name

DIANA M FULAZA

Original Issue Date

11/22/2021

Effective Date

05/13/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60626

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026