MOLLY ELIZABETH FORD Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****61

License Status

INACTIVE

Business

First Name

MOLLY

Middle

ELIZABETH

Last Name

FORD

Business Name

MOLLY ELIZABETH FORD

Original Issue Date

07/07/2016

Effective Date

04/01/2024

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61822

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/27/2025