NISHA SAM GEORGE Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****53

License Status

INACTIVE

Business

First Name

NISHA

Middle

SAM

Last Name

GEORGE

Business Name

NISHA SAM GEORGE

Original Issue Date

10/01/2013

Effective Date

03/25/2024

Expiration Date

05/31/2026

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/30/2024