JUDITH MONGOUM PENE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****64

License Status

ACTIVE

Business

First Name

JUDITH

Last Name

MONGOUM PENE

Business Name

JUDITH MONGOUM PENE

Original Issue Date

05/28/2021

Effective Date

03/28/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60654

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026