SHANNA M WIDERA Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****71

License Status

INOPERATIVE

Business

First Name

SHANNA

Middle

Last Name

WIDERA

Business Name

SHANNA M WIDERA

Original Issue Date

07/11/2008

Effective Date

09/16/2020

Expiration Date

05/31/2022

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2022