ANDRILYN A JAVELLANA NEDEDOG Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****70

License Status

NOT RENEWED

Business

First Name

ANDRILYN A

Middle

JAVELLANA

Last Name

NEDEDOG

Business Name

ANDRILYN A JAVELLANA NEDEDOG

Original Issue Date

10/22/2018

Effective Date

06/01/2022

Expiration Date

06/30/2024

City

LAKE VILLA

State

Zip

60046

County

COOK

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025