JENNIFER LEE BROKAW Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****47

License Status

ACTIVE

Business

First Name

JENNIFER

Middle

LEE

Last Name

BROKAW

Business Name

JENNIFER LEE BROKAW

Original Issue Date

07/19/2001

Effective Date

04/24/2024

Expiration Date

05/31/2026

City

GENESEO

State

Zip

61254

County

HENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026