NIKKI JO BLACKMAN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

INACTIVE

Business

First Name

NIKKI

Middle

Last Name

BLACKMAN

Business Name

NIKKI JO BLACKMAN

Original Issue Date

12/05/2013

Effective Date

05/10/2022

Expiration Date

05/31/2024

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/31/2023