LISSA C BLAHNIK Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209005387

License Status

INACTIVE

Business

First Name

LISSA

Middle

Last Name

BLAHNIK

Business Name

LISSA C BLAHNIK

Original Issue Date

12/01/2004

Effective Date

03/11/2008

Expiration Date

05/31/2010

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

03/05/2010