SUSAN FAIRLEY-HOLBACH 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

SUSAN

Last Name

FAIRLEY-HOLBACH

Business Name

SUSAN FAIRLEY-HOLBACH

Original Issue Date

03/05/2009

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

ZION

State

Zip

60099

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2026