ASHLEY R BLACK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****99

License Status

ACTIVE

Business

First Name

ASHLEY

Middle

Last Name

BLACK

Business Name

ASHLEY R BLACK

Original Issue Date

10/04/2017

Effective Date

04/26/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60614

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026