MARILYN BARBARA BLAKE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041178552

License Status

INACTIVE

Business

First Name

MARILYN BARBARA

Last Name

BLAKE

Business Name

MARILYN BARBARA BLAKE

Original Issue Date

11/07/1977

Effective Date

11/07/1977

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/27/2006