MARILOU L PENA 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

MARILOU L

Last Name

PENA

Business Name

MARILOU L PENA

Original Issue Date

05/14/2009

Effective Date

05/26/2020

Expiration Date

08/31/2022

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/14/2022