LICENSE	R-257-TA-B06
FIRST NAME	Rachana
MIDDLE INITIAL	P.
LAST NAME	Carrizales
SUFFIX
ADDRESS	2623 Accolade Ave
CITY	Naperville
STATE	IL
ORIGINAL LICENSE DATE	7/21/2017
DISCIPLINE	N
DISCIPLINE DATE
VALID THRU	12/31/2018
DISCIPLINARY ACTION