JENNA NICOLE FORD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****97

License Status

ACTIVE

Business

First Name

JENNA

Middle

NICOLE

Last Name

FORD

Business Name

JENNA NICOLE FORD

Original Issue Date

06/22/2016

Effective Date

04/11/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026