MELISSA THIBAULT MIKOTA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****98

License Status

ACTIVE

Business

First Name

MELISSA

Middle

THIBAULT

Last Name

MIKOTA

Business Name

MELISSA THIBAULT MIKOTA

Original Issue Date

11/02/2022

Effective Date

03/14/2024

Expiration Date

05/31/2026

City

THIRD LAKE

State

Zip

60030

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026