MARY R BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041262067

License Status

NOT RENEWED

Business

First Name

MARY R

Last Name

BLACK

Business Name

MARY R BLACK

Original Issue Date

04/12/1991

Effective Date

04/12/1991

Expiration Date

05/31/1996

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/27/2006