MILDRED M BLAKE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043016055

License Status

NOT RENEWED

Business

First Name

MILDRED M

Last Name

BLAKE

Business Name

MILDRED M BLAKE

Original Issue Date

09/16/1966

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/21/2005