TIMOTHY L FORD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****76

License Status

ACTIVE

Business

First Name

TIMOTHY

Middle

Last Name

FORD

Business Name

TIMOTHY L FORD

Original Issue Date

02/07/2017

Effective Date

03/06/2024

Expiration Date

05/31/2026

City

MARION

State

Zip

62959

County

WILLIAMSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026