FREDA ANN BLACK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209005685

License Status

NOT RENEWED

Business

First Name

FREDA

Middle

ANN

Last Name

BLACK

Business Name

FREDA ANN BLACK

Original Issue Date

08/30/2005

Effective Date

04/21/2014

Expiration Date

05/31/2016

City

PORTAGE

State

Zip

46368

County

INDIANA

Ever Disciplined

LastModifiedDate

07/11/2016