TANYA R CHAMPA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****28

License Status

NOT RENEWED

Business

First Name

TANYA

Middle

Last Name

CHAMPA

Business Name

TANYA R CHAMPA

Original Issue Date

02/20/2007

Effective Date

03/05/2010

Expiration Date

05/31/2012

City

OAK BROOK

State

Zip

60523

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/10/2012