HEATHER M KMIECIK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****42

License Status

ACTIVE

Business

First Name

HEATHER

Middle

Last Name

KMIECIK

Business Name

HEATHER M KMIECIK

Original Issue Date

02/05/2020

Effective Date

04/17/2024

Expiration Date

05/31/2026

City

BLUE ISLAND

State

Zip

60406

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026