AMANDA L COCKRELL-TAPALLA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****74

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

COCKRELL-TAPALLA

Business Name

AMANDA L COCKRELL-TAPALLA

Original Issue Date

05/06/2016

Effective Date

04/13/2018

Expiration Date

09/30/2020

City

LYONS

State

Zip

60534

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021