DONALD WAYNE BLOM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041183362

License Status

NOT RENEWED

Business

First Name

DONALD WAYNE

Last Name

BLOM

Business Name

DONALD WAYNE BLOM

Original Issue Date

10/16/1978

Effective Date

04/25/2014

Expiration Date

05/31/2016

City

RIVERSIDE

State

Zip

60546

County

COOK

Ever Disciplined

LastModifiedDate

07/11/2016