ANDREW OWEN KOCH Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****96

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

OWEN

Last Name

KOCH

Business Name

ANDREW OWEN KOCH

Original Issue Date

03/06/2019

Effective Date

03/06/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60615

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021