DEIDRA R FONTANA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****51

License Status

NOT RENEWED

Business

First Name

DEIDRA R

Last Name

FONTANA

Business Name

DEIDRA R FONTANA

Original Issue Date

11/21/2003

Effective Date

03/23/2010

Expiration Date

05/31/2012

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2012