RACHEL ANNE BREIVALD Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****82

License Status

NOT RENEWED

Business

First Name

RACHEL

Middle

ANNE

Last Name

BREIVALD

Business Name

RACHEL ANNE BREIVALD

Original Issue Date

10/16/2007

Effective Date

05/14/2018

Expiration Date

09/30/2020

City

PARK RIDGE

State

Zip

60068

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021