ROSA I MATHIS Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****23

License Status

ACTIVE

Business

First Name

ROSA

Middle

Last Name

MATHIS

Business Name

ROSA I MATHIS

Original Issue Date

07/14/2021

Effective Date

05/17/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60611

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026