ELLISSA MICHELLE BLAKE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041452934

License Status

NOT RENEWED

Business

First Name

ELLISSA

Middle

MICHELLE

Last Name

BLAKE

Business Name

ELLISSA MICHELLE BLAKE

Original Issue Date

05/17/2017

Effective Date

04/11/2018

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61821

County

MICHIGAN

Ever Disciplined

LastModifiedDate

01/14/2021