CODY JACKSON MEYER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****96

License Status

ACTIVE

Business

First Name

CODY

Middle

JACKSON

Last Name

MEYER

Business Name

CODY JACKSON MEYER

Original Issue Date

10/23/2023

Effective Date

04/18/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026