SHIREEN V LONG Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****97

License Status

INACTIVE

Business

First Name

SHIREEN

Middle

Last Name

LONG

Business Name

SHIREEN V LONG

Original Issue Date

10/30/2014

Effective Date

04/03/2018

Expiration Date

09/30/2020

City

MORTON GROVE

State

Zip

60053

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/02/2018