MARIELLEN P ANTMAN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****47

License Status

ACTIVE

Business

First Name

MARIELLEN

Middle

Last Name

ANTMAN

Business Name

MARIELLEN P ANTMAN

Original Issue Date

07/16/2004

Effective Date

03/06/2026

Expiration Date

05/31/2028

City

LAKE FOREST

State

Zip

60045

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/06/2026