MARYAM DIAZ 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

MARYAM

Last Name

DIAZ

Business Name

MARYAM DIAZ

Original Issue Date

09/17/2019

Effective Date

05/01/2024

Expiration Date

05/31/2026

City

OAK PARK

State

Zip

60302

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026