ENRIQUETA R GOMEZ Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****67

License Status

NOT RENEWED

Business

First Name

ENRIQUETA

Middle

Last Name

GOMEZ

Business Name

ENRIQUETA R GOMEZ

Original Issue Date

04/03/2019

Effective Date

04/03/2019

Expiration Date

09/30/2020

City

WAUKEGAN

State

Zip

60085

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021