TIFFANY N LOGAN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****64

License Status

ACTIVE

Business

First Name

TIFFANY

Middle

Last Name

LOGAN

Business Name

TIFFANY N LOGAN

Original Issue Date

11/12/2021

Effective Date

03/15/2024

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