TEDRA D GRAY Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****57

License Status

INACTIVE

Business

First Name

TEDRA

Middle

Last Name

GRAY

Business Name

TEDRA D GRAY

Original Issue Date

09/13/2005

Effective Date

05/24/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60617

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/05/2025