MARIE ELISABETH FREDERICK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****63

License Status

NOT RENEWED

Business

First Name

MARIE

Middle

ELISABETH

Last Name

FREDERICK

Business Name

MARIE ELISABETH FREDERICK

Original Issue Date

11/12/2021

Effective Date

11/12/2021

Expiration Date

08/31/2022

City

WILLOWBROOK

State

Zip

60527

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022