SUSAN LEE BLOOM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041108378

License Status

NOT RENEWED

Business

First Name

SUSAN LEE

Last Name

BLOOM

Business Name

SUSAN LEE BLOOM

Original Issue Date

12/06/1963

Effective Date

07/21/2008

Expiration Date

05/31/2010

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

08/16/2010