POLLY PETERSEN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****86

License Status

NOT RENEWED

Business

First Name

POLLY

Last Name

PETERSEN

Business Name

POLLY PETERSEN

Original Issue Date

08/11/2004

Effective Date

08/11/2004

Expiration Date

05/31/2008

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

07/11/2008