JENNIFER LEE BLACK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209016989

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

LEE

Last Name

BLACK

Business Name

JENNIFER LEE BLACK

Original Issue Date

12/12/2017

Effective Date

06/16/2022

Expiration Date

06/30/2024

City

SAINT JACOB

State

Zip

62281

County

MADISON

Ever Disciplined

LastModifiedDate

02/05/2025