JENNIFER M CLARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****89

License Status

ACTIVE

Business

First Name

JENNIFER

Middle

Last Name

CLARK

Business Name

JENNIFER M CLARK

Original Issue Date

08/25/2021

Effective Date

03/23/2026

Expiration Date

05/31/2028

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/23/2026