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*****82

License Status

INOPERATIVE

Business

First Name

FREDA

Middle

ANN

Last Name

BLACK

Business Name

FREDA ANN BLACK

Original Issue Date

10/06/2011

Effective Date

04/03/2012

Expiration Date

05/31/2014

City

GLENWOOD

State

Zip

60425

County

COOK

Ever Disciplined

LastModifiedDate

04/02/2012