KRISTINA NICOLE SOUTHERLAND Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****43

License Status

ACTIVE

Business

First Name

KRISTINA

Middle

NICOLE

Last Name

SOUTHERLAND

Business Name

KRISTINA NICOLE SOUTHERLAND

Original Issue Date

03/10/2021

Effective Date

05/20/2024

Expiration Date

05/31/2026

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026