JACOB P SANDERS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****20

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

Last Name

SANDERS

Business Name

JACOB P SANDERS

Original Issue Date

12/31/2014

Effective Date

04/06/2020

Expiration Date

08/31/2022

City

MC LEANSBORO

State

Zip

62859

County

HAMILTON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022