MARY BLACK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043028631

License Status

INACTIVE

Business

First Name

MARY

Last Name

BLACK

Business Name

MARY BLACK

Original Issue Date

06/29/1971

Effective Date

12/15/2010

Expiration Date

01/31/2013

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Ever Disciplined

LastModifiedDate

11/08/2012