SUNIL SAM 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

SUNIL

Last Name

SAM

Business Name

SUNIL SAM

Original Issue Date

07/09/2021

Effective Date

05/26/2022

Expiration Date

05/31/2024

City

CHICAGO

State

Zip

60617

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2024