JUSTIN JOSEPH COUCH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****65

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

JOSEPH

Last Name

COUCH

Business Name

JUSTIN JOSEPH COUCH

Original Issue Date

07/21/2016

Effective Date

04/12/2024

Expiration Date

05/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026