JUDITH B SUPANICH Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****36

License Status

NOT RENEWED

Business

First Name

JUDITH

Middle

Last Name

SUPANICH

Business Name

JUDITH B SUPANICH

Original Issue Date

11/20/2007

Effective Date

04/23/2010

Expiration Date

05/31/2012

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2012