MARY D BLACK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043045386

License Status

INACTIVE

Business

First Name

MARY D

Last Name

BLACK

Business Name

MARY D BLACK

Original Issue Date

01/26/1979

Effective Date

11/03/2006

Expiration Date

01/31/2009

City

MT ZION

State

Zip

62549

County

MACON

Ever Disciplined

LastModifiedDate

11/10/2008