BLAKE WILLIAM RANDLES Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****67

License Status

ACTIVE

Business

First Name

BLAKE

Middle

WILLIAM

Last Name

RANDLES

Business Name

BLAKE WILLIAM RANDLES

Original Issue Date

04/10/2025

Effective Date

04/10/2025

Expiration Date

05/31/2026

City

HILLSBORO

State

Zip

62049

County

MONTGOMERY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026