SHAWNTELL M JACKSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

NOT RENEWED

Business

First Name

SHAWNTELL

Middle

Last Name

JACKSON

Business Name

SHAWNTELL M JACKSON

Original Issue Date

02/06/2020

Effective Date

05/17/2022

Expiration Date

06/30/2024

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025