CARMELLA A JACKSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****58

License Status

NOT RENEWED

Business

First Name

CARMELLA

Middle

Last Name

JACKSON

Business Name

CARMELLA A JACKSON

Original Issue Date

03/17/2020

Effective Date

07/16/2022

Expiration Date

06/30/2024

City

MATTESON

State

Zip

60443

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025