WYVON L BLACKWELL Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209011447

License Status

INACTIVE

Business

First Name

WYVON

Middle

Last Name

BLACKWELL

Business Name

WYVON L BLACKWELL

Original Issue Date

04/04/2014

Effective Date

05/04/2018

Expiration Date

09/30/2020

City

MATTESON

State

Zip

60443

County

COOK

Ever Disciplined

LastModifiedDate

03/08/2020