SYDNEY L SHACKELFORD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

ACTIVE

Business

First Name

SYDNEY

Middle

Last Name

SHACKELFORD

Business Name

SYDNEY L SHACKELFORD

Original Issue Date

08/12/2023

Effective Date

05/06/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026