MOHAMAD ATA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****79

License Status

ACTIVE

Business

First Name

MOHAMAD

Last Name

ATA

Business Name

MOHAMAD ATA

Original Issue Date

07/16/2018

Effective Date

04/15/2024

Expiration Date

05/31/2026

City

PALOS HEIGHTS

State

Zip

60463

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026