HALEIGH N MOSS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****35

License Status

NOT RENEWED

Business

First Name

HALEIGH

Middle

Last Name

MOSS

Business Name

HALEIGH N MOSS

Original Issue Date

11/06/2019

Effective Date

04/06/2020

Expiration Date

08/31/2022

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/14/2022