JENNIFER LEE BLACK Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****47

License Status

INOPERATIVE

Business

First Name

JENNIFER

Middle

LEE

Last Name

BLACK

Business Name

JENNIFER LEE BLACK

Original Issue Date

03/21/2018

Effective Date

07/21/2020

Expiration Date

05/31/2022

City

CARLYLE

State

Zip

62231

County

CLINTON

Ever Disciplined

LastModifiedDate

05/02/2022