SAMANTHA ELIZABETH MARTIN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****95

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

ELIZABETH

Last Name

MARTIN

Business Name

SAMANTHA ELIZABETH MARTIN

Original Issue Date

08/21/2017

Effective Date

04/17/2018

Expiration Date

09/30/2020

City

EUREKA

State

Zip

61530

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021