NICOLE R MOSS Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****99

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

MOSS

Business Name

NICOLE R MOSS

Original Issue Date

08/26/2021

Effective Date

05/03/2024

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026