GWENDOLYN RAE RIDDELL Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****93

License Status

NOT RENEWED

Business

First Name

GWENDOLYN

Middle

RAE

Last Name

RIDDELL

Business Name

GWENDOLYN RAE RIDDELL

Original Issue Date

11/19/2004

Effective Date

11/19/2004

Expiration Date

05/31/2008

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

07/11/2008