TERESA M BLAIR Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****47

License Status

NOT RENEWED

Business

First Name

TERESA M

Last Name

BLAIR

Business Name

TERESA M BLAIR

Original Issue Date

11/25/2008

Effective Date

03/20/2018

Expiration Date

09/30/2020

City

WARREN

State

Zip

61087

County

CARROLL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021