LESLIE ANN FERMIN DEPAYSO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****10

License Status

ACTIVE

Business

First Name

LESLIE ANN

Middle

FERMIN

Last Name

DEPAYSO

Business Name

LESLIE ANN FERMIN DEPAYSO

Original Issue Date

12/23/2024

Effective Date

03/07/2026

Expiration Date

05/31/2028

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/07/2026