ZACHARY M FORD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****48

License Status

ACTIVE

Business

First Name

ZACHARY

Middle

Last Name

FORD

Business Name

ZACHARY M FORD

Original Issue Date

07/28/2022

Effective Date

05/28/2024

Expiration Date

05/31/2026

City

GRANITE CITY

State

Zip

62040

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026