LESLIE G VILLALOBOS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

NOT RENEWED

Business

First Name

LESLIE

Middle

Last Name

VILLALOBOS

Business Name

LESLIE G VILLALOBOS

Original Issue Date

01/13/2020

Effective Date

01/13/2020

Expiration Date

09/30/2020

City

WAUKEGAN

State

Zip

60085

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021