MARIANE MANALO DOMINGO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****83

License Status

ACTIVE

Business

First Name

MARIANE

Middle

MANALO

Last Name

DOMINGO

Business Name

MARIANE MANALO DOMINGO

Original Issue Date

06/16/2017

Effective Date

04/25/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026