WYVON L BLACKWELL Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****62

License Status

INACTIVE

Business

First Name

WYVON

Middle

Last Name

BLACKWELL

Business Name

WYVON L BLACKWELL

Original Issue Date

12/17/2014

Effective Date

03/01/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60621

County

COOK

Ever Disciplined

LastModifiedDate

03/08/2020