LARISA GEORGIANA BASA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****58

License Status

ACTIVE

Business

First Name

LARISA

Middle

GEORGIANA

Last Name

BASA

Business Name

LARISA GEORGIANA BASA

Original Issue Date

08/22/2022

Effective Date

04/11/2024

Expiration Date

05/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026