MONA JAGDISH PATEL 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

MONA

Middle

JAGDISH

Last Name

PATEL

Business Name

MONA JAGDISH PATEL

Original Issue Date

09/28/2017

Effective Date

05/18/2018

Expiration Date

09/30/2020

City

WILLOWBROOK

State

Zip

60527

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021