JACLYN LEE LEIBFORTH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****80

License Status

ACTIVE

Business

First Name

JACLYN

Middle

LEE

Last Name

LEIBFORTH

Business Name

JACLYN LEE LEIBFORTH

Original Issue Date

05/28/2024

Effective Date

03/17/2026

Expiration Date

05/31/2028

City

MAYWOOD

State

Zip

60153

County

OKLAHOMA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2026