LILLY H PARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****51

License Status

ACTIVE

Business

First Name

LILLY

Middle

Last Name

PARK

Business Name

LILLY H PARK

Original Issue Date

10/14/2023

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2026