SHIVA TAFFAZOLI 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

SHIVA

Last Name

TAFFAZOLI

Business Name

SHIVA TAFFAZOLI

Original Issue Date

10/19/2015

Effective Date

03/13/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60659

County

COOK

Ever Disciplined

LastModifiedDate

03/12/2018