MICAH D HAMM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****39

License Status

ACTIVE

Business

First Name

MICAH

Middle

Last Name

HAMM

Business Name

MICAH D HAMM

Original Issue Date

10/26/2020

Effective Date

03/11/2026

Expiration Date

05/31/2028

City

VANDALIA

State

Zip

62471

County

FAYETTE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2026