STEPHANIE D JACKSON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****01

License Status

ACTIVE

Business

First Name

STEPHANIE

Middle

Last Name

JACKSON

Business Name

STEPHANIE D JACKSON

Original Issue Date

06/22/2022

Effective Date

05/24/2024

Expiration Date

05/31/2026

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026