SUSAN J BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041210706

License Status

NOT RENEWED

Business

First Name

SUSAN J

Last Name

BLACK

Business Name

SUSAN J BLACK

Original Issue Date

08/03/1982

Effective Date

05/03/2022

Expiration Date

06/30/2024

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/05/2025