DEIDRA C SANFORD Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****61

License Status

NOT RENEWED

Business

First Name

DEIDRA

Middle

Last Name

SANFORD

Business Name

DEIDRA C SANFORD

Original Issue Date

03/15/2021

Effective Date

03/15/2021

Expiration Date

08/31/2022

City

CHICAGO

State

Zip

60652

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022