TARA DEDIC HENRIKSON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****37

License Status

ACTIVE

Business

First Name

TARA

Middle

DEDIC

Last Name

HENRIKSON

Business Name

TARA DEDIC HENRIKSON

Original Issue Date

12/17/2012

Effective Date

03/30/2024

Expiration Date

05/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026