KATHLEEN CAROL DAVIS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****54

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

CAROL

Last Name

DAVIS

Business Name

KATHLEEN CAROL DAVIS

Original Issue Date

09/12/2018

Effective Date

09/12/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021