MARY A CRISOSTOMO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****66

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

CRISOSTOMO

Business Name

MARY A CRISOSTOMO

Original Issue Date

07/02/2013

Effective Date

03/15/2018

Expiration Date

09/30/2020

City

HINSDALE

State

Zip

60521

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021