ENRIQUETA R GOMEZ Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****59

License Status

NOT RENEWED

Business

First Name

ENRIQUETA

Middle

Last Name

GOMEZ

Business Name

ENRIQUETA R GOMEZ

Original Issue Date

11/09/2019

Effective Date

05/26/2020

Expiration Date

08/31/2022

City

NILES

State

Zip

60714

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022