TIFFANY HICKS GARDNER Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****37

License Status

INACTIVE

Business

First Name

TIFFANY

Middle

HICKS

Last Name

GARDNER

Business Name

TIFFANY HICKS GARDNER

Original Issue Date

09/11/2018

Effective Date

03/07/2024

Expiration Date

05/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/13/2024