JUSTIN MATTHEW JEFFERSON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

MATTHEW

Last Name

JEFFERSON

Business Name

JUSTIN MATTHEW JEFFERSON

Original Issue Date

06/20/2023

Effective Date

06/28/2024

Expiration Date

05/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026