BLAKE KATHLEEN GOMEZ Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****97

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

KATHLEEN

Last Name

GOMEZ

Business Name

BLAKE KATHLEEN GOMEZ

Original Issue Date

02/20/2019

Effective Date

06/09/2022

Expiration Date

06/30/2024

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

02/05/2025