JILL R MARTIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****78

License Status

ACTIVE

Business

First Name

JILL

Middle

Last Name

MARTIN

Business Name

JILL R MARTIN

Original Issue Date

11/26/2019

Effective Date

04/13/2024

Expiration Date

05/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026