CATHERINE L BLAKE Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****48

License Status

NOT RENEWED

Business

First Name

CATHERINE L

Last Name

BLAKE

Business Name

CATHERINE L BLAKE

Original Issue Date

11/16/2006

Effective Date

05/13/2012

Expiration Date

05/31/2014

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/03/2014