GERALD S MARTIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****40

License Status

ACTIVE

Business

First Name

GERALD S

Last Name

MARTIN

Business Name

GERALD S MARTIN

Original Issue Date

03/14/2017

Effective Date

03/26/2026

Expiration Date

05/31/2028

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/26/2026