MARY J BLACK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041293493

License Status

INACTIVE

Business

First Name

MARY J

Last Name

BLACK

Business Name

MARY J BLACK

Original Issue Date

10/30/1995

Effective Date

05/13/2020

Expiration Date

08/31/2022

City

SANDWICH

State

Zip

60548

County

DEKALB

Ever Disciplined

LastModifiedDate

08/31/2022