TAMMY J MORAN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****54

License Status

INOPERATIVE

Business

First Name

TAMMY

Middle

Last Name

MORAN

Business Name

TAMMY J MORAN

Original Issue Date

05/20/2002

Effective Date

01/27/2020

Expiration Date

03/01/2022

City

ROCK FALLS

State

Zip

61071

County

WHITESIDE

Ever Disciplined

LastModifiedDate

01/03/2022