SAMUEL T ASSAM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****93

License Status

ACTIVE

Business

First Name

SAMUEL

Middle

Last Name

ASSAM

Business Name

SAMUEL T ASSAM

Original Issue Date

03/17/2023

Effective Date

04/10/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60607

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026