JUDITH A BLACK Registered Nurse License verification

JUDITH A BLACK

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041111644

License Status

NOT RENEWED

Business

First Name

JUDITH

Middle

Last Name

BLACK

Business Name

JUDITH A BLACK

Original Issue Date

11/25/1964

Effective Date

03/15/2010

Expiration Date

05/31/2012

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/10/2012

Case Number

2009008142

Action

Suspension

Discipline Start Date

04/22/2011

Discipline Reason

for forging the name of a nurse practitioner on hepatitis panels without authority and without a physician's order and also ordered a urinalysis without a physician's order.