MONA LISA JIMENEZ 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

MONA

Middle

LISA

Last Name

JIMENEZ

Business Name

MONA LISA JIMENEZ

Original Issue Date

07/16/2020

Effective Date

07/16/2020

Expiration Date

08/31/2022

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022