KATHERYNE TIFUH AMBA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****95

License Status

NOT RENEWED

Business

First Name

KATHERYNE

Middle

TIFUH

Last Name

AMBA

Business Name

KATHERYNE TIFUH AMBA

Original Issue Date

11/28/2011

Effective Date

03/20/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60649

County

MISSOURI

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021