TAMARA DENISE GORMAN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****39

License Status

ACTIVE

Business

First Name

TAMARA

Middle

DENISE

Last Name

GORMAN

Business Name

TAMARA DENISE GORMAN

Original Issue Date

10/25/2024

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026