JONATHAN ROBERT MIZGALA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****62

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

ROBERT

Last Name

MIZGALA

Business Name

JONATHAN ROBERT MIZGALA

Original Issue Date

07/31/2017

Effective Date

04/12/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021