NICOLE M CHUM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****73

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

CHUM

Business Name

NICOLE M CHUM

Original Issue Date

09/17/2022

Effective Date

05/06/2024

Expiration Date

05/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026