OTISTINE BLACKMON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043013809

License Status

NOT RENEWED

Business

First Name

OTISTINE

Last Name

BLACKMON

Business Name

OTISTINE BLACKMON

Original Issue Date

10/07/1965

Expiration Date

01/31/1987

City

CHICAGO

State

Zip

60628

County

COOK

Ever Disciplined

LastModifiedDate

10/21/2005