JENNIFER D BLAYLOCK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****27

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

BLAYLOCK

Business Name

JENNIFER D BLAYLOCK

Original Issue Date

07/21/2010

Effective Date

05/23/2017

Expiration Date

05/31/2018

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/19/2018