JUDITH A LIDY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****68

License Status

ACTIVE

Business

First Name

JUDITH A

Last Name

LIDY

Business Name

JUDITH A LIDY

Original Issue Date

09/21/2001

Effective Date

05/15/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026