ANILTTA ALEX Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****83

License Status

INACTIVE

Business

First Name

ANILTTA

Last Name

ALEX

Business Name

ANILTTA ALEX

Original Issue Date

08/07/2007

Effective Date

04/18/2018

Expiration Date

09/30/2020

City

ELMHURST

State

Zip

60126

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2019