ZACHARY OLSON BURGESS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****55

License Status

NOT RENEWED

Business

First Name

ZACHARY

Middle

OLSON

Last Name

BURGESS

Business Name

ZACHARY OLSON BURGESS

Original Issue Date

12/22/2016

Effective Date

03/21/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60637

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021