JEAN A RUSSO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****24

License Status

NOT RENEWED

Business

First Name

JEAN

Middle

Last Name

RUSSO

Business Name

JEAN A RUSSO

Original Issue Date

11/08/2007

Effective Date

05/18/2018

Expiration Date

09/30/2020

City

SKOKIE

State

Zip

60076

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021