JONATHAN AARON RIDER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****67

License Status

ACTIVE

Business

First Name

JONATHAN

Middle

AARON

Last Name

RIDER

Business Name

JONATHAN AARON RIDER

Original Issue Date

08/24/2015

Effective Date

04/21/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61615

County

MACON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026