AUTUMN SEUNGHEE SONG 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

AUTUMN

Middle

SEUNGHEE

Last Name

SONG

Business Name

AUTUMN SEUNGHEE SONG

Original Issue Date

03/20/2023

Effective Date

03/20/2023

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60612

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025