CASSIDY BOMA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

ACTIVE

Business

First Name

CASSIDY

Last Name

BOMA

Business Name

CASSIDY BOMA

Original Issue Date

05/17/2023

Effective Date

03/12/2024

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026