MACKENZIE BLACKBURN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****05

License Status

ACTIVE

Business

First Name

MACKENZIE

Last Name

BLACKBURN

Business Name

MACKENZIE BLACKBURN

Original Issue Date

01/17/2025

Effective Date

03/24/2026

Expiration Date

05/31/2028

City

WARRENVILLE

State

Zip

60555

Delegated Controlled Substance Schedule

II III V

Ever Disciplined

LastModifiedDate

03/24/2026