GORDON JOHN MESA Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****92

License Status

INACTIVE

Business

First Name

GORDON

Middle

JOHN

Last Name

MESA

Business Name

GORDON JOHN MESA

Original Issue Date

12/14/2015

Effective Date

05/09/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60618

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2018