LATHA S PANICKER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****50

License Status

ACTIVE

Business

First Name

LATHA S

Last Name

PANICKER

Business Name

LATHA S PANICKER

Original Issue Date

12/20/2012

Effective Date

03/05/2024

Expiration Date

05/31/2026

City

WESTMONT

State

Zip

60559

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026