JONATHAN RICHARD WIESE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****75

License Status

ACTIVE

Business

First Name

JONATHAN

Middle

RICHARD

Last Name

WIESE

Business Name

JONATHAN RICHARD WIESE

Original Issue Date

05/12/2025

Effective Date

05/12/2025

Expiration Date

05/31/2026

City

SAINT LOUIS

State

Zip

63110

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026