Verification of Nurse Licensure in Idaho - Board of Nursing

Type of License: LPN RN APRN Date Issued: Original License Number: I hereby authorize the Board of Nursing to release the information requested below to the Idaho Board of Nursing: Signature: Date: License Verification LPN or RN Licensure Type of License: LPN RN License Number: Active: Yes or No . Expiration Date: ................
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