KATHLEEN P MICKOW Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****35

License Status

ACTIVE

Business

First Name

KATHLEEN

Middle

Last Name

MICKOW

Business Name

KATHLEEN P MICKOW

Original Issue Date

03/21/2011

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2026