HEIDI A WAGNER Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****64

License Status

NOT RENEWED

Business

First Name

HEIDI A

Last Name

WAGNER

Business Name

HEIDI A WAGNER

Original Issue Date

03/17/2017

Effective Date

03/17/2017

Expiration Date

05/31/2018

City

CHICAGO

State

Zip

60606

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2018