Berna Bungabong Moore
ExpiredIllinois license 085006189
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 085006189
- Status
- Expired (Not Renewed)
- First issued
- May 2, 2017
- Expired
- March 1, 2024
- License holder
- Berna Bungabong Moore
- Entity type
- Individual
Classifications
- Licensed Physician Assistant Physicians & Surgeons
More from the license record
- Current term began
- 01/29/2022
Contact
San Diego, CA 92121