JOHN J PARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****02

License Status

ACTIVE

Business

First Name

JOHN

Middle

Last Name

PARK

Business Name

JOHN J PARK

Original Issue Date

09/16/2024

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026