CYNTHIA L BANTISTA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****83

License Status

NOT RENEWED

Business

First Name

CYNTHIA

Middle

Last Name

BANTISTA

Business Name

CYNTHIA L BANTISTA

Original Issue Date

02/16/2019

Effective Date

02/16/2019

Expiration Date

09/30/2020

City

HINSDALE

State

Zip

60521

County

DUPAGE

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021