FABRIZIO DIANA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****72

License Status

NOT RENEWED

Business

First Name

FABRIZIO

Last Name

DIANA

Business Name

FABRIZIO DIANA

Original Issue Date

05/08/2017

Effective Date

04/17/2018

Expiration Date

09/30/2020

City

NEW YORK

State

Zip

10029

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021