TRACI L BLAKE Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041336983

License Status

ACTIVE

Business

First Name

TRACI

Middle

Last Name

BLAKE

Business Name

TRACI L BLAKE

Original Issue Date

08/22/2003

Effective Date

03/23/2024

Expiration Date

05/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/28/2026