JORDAN JAE BLICKENSTAFF Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041398380

License Status

INACTIVE

Business

First Name

JORDAN

Middle

JAE

Last Name

BLICKENSTAFF

Business Name

JORDAN JAE BLICKENSTAFF

Original Issue Date

12/19/2011

Effective Date

04/12/2016

Expiration Date

05/31/2018

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

03/06/2018