TYLER LEIGH JOHNSON Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****02

License Status

INACTIVE

Business

First Name

TYLER

Middle

LEIGH

Last Name

JOHNSON

Business Name

TYLER LEIGH JOHNSON

Original Issue Date

11/04/2021

Effective Date

05/30/2024

Expiration Date

05/31/2026

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/09/2025