SUMAN GOWDA SHAW Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****96

License Status

ACTIVE

Business

First Name

SUMAN

Middle

GOWDA

Last Name

SHAW

Business Name

SUMAN GOWDA SHAW

Original Issue Date

03/26/2020

Effective Date

04/22/2024

Expiration Date

05/31/2026

City

NAPERVILLE

State

Zip

60564

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026