JACQUELINE WIRTH 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

JACQUELINE

Last Name

WIRTH

Business Name

JACQUELINE WIRTH

Original Issue Date

08/03/2022

Effective Date

08/03/2022

Expiration Date

06/30/2024

City

SYCAMORE

State

Zip

60178

County

DEKALB

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025