FREDA ANN BLACK Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

INOPERATIVE

Business

First Name

FREDA

Middle

ANN

Last Name

BLACK

Business Name

FREDA ANN BLACK

Original Issue Date

08/30/2005

Effective Date

04/21/2014

Expiration Date

05/31/2016

City

GLENWOOD

State

Zip

60425

County

COOK

Ever Disciplined

LastModifiedDate

04/21/2014