BLAKE KATHLEEN GOMEZ Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209018598

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

KATHLEEN

Last Name

GOMEZ

Business Name

BLAKE KATHLEEN GOMEZ

Original Issue Date

01/04/2019

Effective Date

06/09/2022

Expiration Date

06/30/2024

City

WOODBURY

State

Zip

55129

Ever Disciplined

LastModifiedDate

02/05/2025