BEVERLY PONTA BLACK - Registered Nurse License in Illinois | # 043041108

BEVERLY PONTA BLACK

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043041108

License Status

NOT RENEWED

Business

N

First Name

BEVERLY PONTA

Last Name

BLACK

Business Name

BEVERLY PONTA BLACK

Original Issue Date

02/02/1977

Expiration Date

01/31/1987

State

IL

Ever Disciplined

N

LastModifiedDate

10/21/2005