JERALYN FOKKEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****66

License Status

ACTIVE

Business

First Name

JERALYN

Last Name

FOKKEN

Business Name

JERALYN FOKKEN

Original Issue Date

09/14/2024

Effective Date

09/14/2024

Expiration Date

05/31/2026

City

NEW YORK

State

Zip

10013

County

NEW YORK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026