PHYLLIS J BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041247387

License Status

NOT RENEWED

Business

First Name

PHYLLIS J

Last Name

BLACK

Business Name

PHYLLIS J BLACK

Original Issue Date

05/01/1988

Effective Date

04/08/2014

Expiration Date

05/31/2016

City

NEWMAN

State

Zip

61942

County

DOUGLAS

Ever Disciplined

LastModifiedDate

07/11/2016