TETI MARYANN JOHNSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****72

License Status

NOT RENEWED

Business

First Name

TETI

Middle

MARYANN

Last Name

JOHNSON

Business Name

TETI MARYANN JOHNSON

Original Issue Date

02/17/2016

Effective Date

09/17/2020

Expiration Date

08/31/2022

City

ROCKFORD

State

Zip

61104

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022