BANESA CHAVEZ Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****76

License Status

NOT RENEWED

Business

First Name

BANESA

Last Name

CHAVEZ

Business Name

BANESA CHAVEZ

Original Issue Date

09/09/2021

Effective Date

06/29/2022

Expiration Date

06/30/2024

City

BURBANK

State

Zip

60459

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025