THERESE A DENECKE-DATTALO Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****79

License Status

INACTIVE

Business

First Name

THERESE

Middle

Last Name

DENECKE-DATTALO

Business Name

THERESE A DENECKE-DATTALO

Original Issue Date

10/24/2002

Effective Date

08/11/2022

Expiration Date

05/31/2024

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/03/2024