TINA J KHOUCHABA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****54

License Status

ACTIVE

Business

First Name

TINA

Middle

Last Name

KHOUCHABA

Business Name

TINA J KHOUCHABA

Original Issue Date

04/28/2016

Effective Date

05/20/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60645

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026