DONNA M BLAZENIAK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043042932

License Status

NOT RENEWED

Business

First Name

DONNA

Middle

Last Name

BLAZENIAK

Business Name

DONNA M BLAZENIAK

Original Issue Date

02/14/1978

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

CRESTWOOD

State

Zip

60418

County

COOK

Ever Disciplined

LastModifiedDate

10/15/2005