HEATHER ANN TAYLOR JACKSON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****09

License Status

ACTIVE

Business

First Name

HEATHER

Middle

ANN TAYLOR

Last Name

JACKSON

Business Name

HEATHER ANN TAYLOR JACKSON

Original Issue Date

11/12/2023

Effective Date

05/06/2024

Expiration Date

05/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026