BEVERLY PONTA BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043041108

License Status

NOT RENEWED

Business

First Name

BEVERLY PONTA

Last Name

BLACK

Business Name

BEVERLY PONTA BLACK

Original Issue Date

02/02/1977

Expiration Date

01/31/1987

City

BELLWOOD

State

Zip

60104

County

COOK

Ever Disciplined

LastModifiedDate

10/21/2005