KANDISE R MOONEYHAM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****92

License Status

ACTIVE

Business

First Name

KANDISE

Middle

Last Name

MOONEYHAM

Business Name

KANDISE R MOONEYHAM

Original Issue Date

11/19/2023

Effective Date

06/26/2024

Expiration Date

05/31/2026

City

OSWEGO

State

Zip

60543

County

KENDALL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026