KEVIN M LAGE Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****70

License Status

INACTIVE

Business

First Name

KEVIN

Middle

Last Name

LAGE

Business Name

KEVIN M LAGE

Original Issue Date

05/06/2016

Effective Date

03/13/2018

Expiration Date

09/30/2020

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/12/2018