DORIS L BLAKE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043054390

License Status

NOT RENEWED

Business

First Name

DORIS L

Last Name

BLAKE

Business Name

DORIS L BLAKE

Original Issue Date

07/27/1982

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/15/2005