AGATHA BLACK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043003292

License Status

INACTIVE

Business

First Name

AGATHA

Last Name

BLACK

Business Name

AGATHA BLACK

Original Issue Date

04/01/1953

City

COLCHESTER

State

Zip

62326

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

10/21/2005