KATHERINE TOM Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****97

License Status

NOT RENEWED

Business

First Name

KATHERINE

Last Name

TOM

Business Name

KATHERINE TOM

Original Issue Date

12/29/2016

Effective Date

06/01/2018

Expiration Date

09/30/2020

City

FOREST PARK

State

Zip

60130

County

KANE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021