MARICEL M SULLIVAN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****22

License Status

INACTIVE

Business

First Name

MARICEL

Middle

Last Name

SULLIVAN

Business Name

MARICEL M SULLIVAN

Original Issue Date

10/25/2011

Effective Date

03/20/2018

Expiration Date

09/30/2020

City

ORLAND PARK

State

Zip

60462

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/19/2018