AMY JEAN BAIN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****38

License Status

NOT RENEWED

Business

First Name

AMY

Middle

JEAN

Last Name

BAIN

Business Name

AMY JEAN BAIN

Original Issue Date

11/26/2007

Effective Date

05/24/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60614

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021