MINI PAUL 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

MINI

Last Name

PAUL

Business Name

MINI PAUL

Original Issue Date

07/06/2012

Effective Date

05/06/2018

Expiration Date

09/30/2020

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021