MATEO M BETANZOS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****31

License Status

NOT RENEWED

Business

First Name

MATEO

Middle

Last Name

BETANZOS

Business Name

MATEO M BETANZOS

Original Issue Date

07/19/2019

Effective Date

07/19/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60621

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021