6/15/2015 OR License Verification
http://osbn.oregon.gov/OSBNVerification/Details.aspx?person=a4dea00274dddf11af930021f6000008 1/1
Oregon State Board of Nursing
Verification of Licensure
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Information current as of: 06/15/2015
Query Time: 6/15/2015 1:36:53 PM
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Licensee:Hazel, Nicholas Mark
Gender:Male
City: Eugene
County:Lane
State:OR
LICENSES
License Number Type License Issued Current Status Date Last Renewed License Expiration Date
201030262LPN LPN07/30/2010 Active 09/11/2014 11/28/2016
200812760CNA CNA12/11/2008 Expired 11/20/2012 11/28/2014
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BOARD ORDERS
No disciplinary actions on record.
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* An asterisk (*) after the Active status indicates that a licensee has applied for renewal on time but OSBN has not yet completely processed the
renewal application.
Call the OSBN at 9716730685 for licensure information.
OSBN Discipline Copies of public documents associated with OSBN disciplinary actions taken against a specific licensee after August 2010 are available
online. Copies of disciplinary actions prior to that date may be obtained by written request. You may email your request to
[email protected]. Or, you
may FAX your request, addressed to Rebecca Nyberg, to 9716730684. Please include the licensee's name and license number (if available), along with your
name, company (if applicable), mailing address, phone number and FAX number or email address.