CONSTANCE F BLAISDELL Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****65

License Status

ACTIVE

Business

First Name

CONSTANCE F

Last Name

BLAISDELL

Business Name

CONSTANCE F BLAISDELL

Original Issue Date

03/04/2019

Effective Date

04/04/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026