TRACY I JACKSON 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

TRACY

Middle

Last Name

JACKSON

Business Name

TRACY I JACKSON

Original Issue Date

03/30/2017

Effective Date

05/06/2024

Expiration Date

05/31/2026

City

EVANSTON

State

Zip

60202

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026