LIAUW D GUNAWAN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****59

License Status

ACTIVE

Business

First Name

LIAUW

Middle

Last Name

GUNAWAN

Business Name

LIAUW D GUNAWAN

Original Issue Date

01/22/2019

Effective Date

04/25/2024

Expiration Date

05/31/2026

City

DES PLAINES

State

Zip

60016

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026