HETA D SHAH Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****43

License Status

INACTIVE

Business

First Name

HETA

Middle

Last Name

SHAH

Business Name

HETA D SHAH

Original Issue Date

12/20/2016

Effective Date

05/21/2022

Expiration Date

05/31/2024

City

BARTLETT

State

Zip

60103

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/31/2023