NANCY ANN MOULTON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****99

License Status

ACTIVE

Business

First Name

NANCY

Middle

ANN

Last Name

MOULTON

Business Name

NANCY ANN MOULTON

Original Issue Date

05/21/2024

Effective Date

01/28/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/28/2026