MICHELLE LYNN JACKSON 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

MICHELLE

Middle

LYNN

Last Name

JACKSON

Business Name

MICHELLE LYNN JACKSON

Original Issue Date

08/24/2019

Effective Date

05/17/2024

Expiration Date

05/31/2026

City

GENESEO

State

Zip

61254

County

HENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026