BENJAMIN G CLARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209029848

License Status

ACTIVE

Business

First Name

BENJAMIN

Middle

Last Name

CLARK

Business Name

BENJAMIN G CLARK

Original Issue Date

06/10/2024

Effective Date

03/09/2026

Expiration Date

05/31/2028

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/09/2026