RYAN P BLAKE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****43

License Status

ACTIVE

Business

First Name

RYAN

Middle

Last Name

BLAKE

Business Name

RYAN P BLAKE

Original Issue Date

06/11/2020

Effective Date

03/20/2024

Expiration Date

05/31/2026

City

JOLIET

State

Zip

60436

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026