BEVERLEY ANN BLAKE-O'DOHERTY Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209024640

License Status

NOT RENEWED

Business

First Name

BEVERLEY

Middle

ANN

Last Name

BLAKE-O'DOHERTY

Business Name

BEVERLEY ANN BLAKE-O'DOHERTY

Original Issue Date

01/06/2022

Effective Date

01/06/2022

Expiration Date

08/31/2022

City

POCATELLO

State

Zip

83204

Ever Disciplined

LastModifiedDate

08/21/2025