JOHNATHAN B REDDICK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****59

License Status

NOT RENEWED

Business

First Name

JOHNATHAN

Middle

Last Name

REDDICK

Business Name

JOHNATHAN B REDDICK

Original Issue Date

04/28/2022

Effective Date

04/28/2022

Expiration Date

06/30/2024

City

BARDWELL

State

Zip

42023

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025