LISA A MOMENT Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****49

License Status

ACTIVE

Business

First Name

LISA

Middle

Last Name

MOMENT

Business Name

LISA A MOMENT

Original Issue Date

03/25/2014

Effective Date

05/01/2024

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026