JORDAN L PETERSON Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****81

License Status

ACTIVE

Business

First Name

JORDAN

Middle

Last Name

PETERSON

Business Name

JORDAN L PETERSON

Original Issue Date

03/22/2022

Effective Date

03/08/2024

Expiration Date

05/31/2026

City

KEWANEE

State

Zip

61443

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026