SALLY JAE WALLIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****76

License Status

ACTIVE

Business

First Name

SALLY

Middle

JAE

Last Name

WALLIN

Business Name

SALLY JAE WALLIN

Original Issue Date

03/22/2017

Effective Date

05/07/2024

Expiration Date

05/31/2026

City

GLENCOE

State

Zip

60022

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026