SUSAN H BLASE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041358223

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

BLASE

Business Name

SUSAN H BLASE

Original Issue Date

02/07/2007

Effective Date

03/12/2010

Expiration Date

05/31/2012

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/10/2012