BEVERLEY ANN BLAKE-O'DOHERTY Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****44

License Status

NOT RENEWED

Business

First Name

BEVERLEY

Middle

ANN

Last Name

BLAKE-O'DOHERTY

Business Name

BEVERLEY ANN BLAKE-O'DOHERTY

Original Issue Date

02/17/2022

Effective Date

02/17/2022

Expiration Date

08/31/2022

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/21/2025