WANDA L BLAKE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041074188

License Status

NOT RENEWED

Business

First Name

WANDA L

Last Name

BLAKE

Business Name

WANDA L BLAKE

Original Issue Date

12/26/1952

Effective Date

12/26/1952

Expiration Date

05/31/1996

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/27/2006