TRACI L BLAKE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209032163

License Status

ACTIVE

Business

First Name

TRACI

Middle

Last Name

BLAKE

Business Name

TRACI L BLAKE

Original Issue Date

04/09/2025

Effective Date

04/09/2025

Expiration Date

05/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/02/2026