LYLE J JACKSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209029217

License Status

NOT RENEWED

Business

First Name

LYLE

Middle

Last Name

JACKSON

Business Name

LYLE J JACKSON

Original Issue Date

01/22/2024

Effective Date

01/22/2024

Expiration Date

06/30/2024

City

REXBURG

State

Zip

83440

Ever Disciplined

LastModifiedDate

02/05/2025