PAULA J WAGNER Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****98

License Status

INACTIVE

Business

First Name

PAULA J

Last Name

WAGNER

Business Name

PAULA J WAGNER

Original Issue Date

06/21/2010

Effective Date

05/12/2022

Expiration Date

06/30/2024

City

EVANSTON

State

Zip

60202

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/03/2024