TYHEATSHA SAMANTHA SHELLY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****46

License Status

ACTIVE

Business

First Name

TYHEATSHA

Middle

SAMANTHA

Last Name

SHELLY

Business Name

TYHEATSHA SAMANTHA SHELLY

Original Issue Date

06/30/2025

Effective Date

06/30/2025

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60622

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026