BERYL J BLALOCK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043063392

License Status

NOT RENEWED

Business

First Name

BERYL J

Last Name

BLALOCK

Business Name

BERYL J BLALOCK

Original Issue Date

07/07/1986

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

CHICAGO

State

Zip

60629

County

COOK

Ever Disciplined

LastModifiedDate

10/15/2005