FARIAHH FAZIL Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****50

License Status

NOT RENEWED

Business

First Name

FARIAHH

Last Name

FAZIL

Business Name

FARIAHH FAZIL

Original Issue Date

02/24/2020

Effective Date

08/30/2022

Expiration Date

06/30/2024

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025