CHRISTOPHER M BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043083251

License Status

NOT RENEWED

Business

First Name

CHRISTOPHER

Middle

Last Name

BLACK

Business Name

CHRISTOPHER M BLACK

Original Issue Date

12/22/1998

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

WATERLOO

State

Zip

62298

County

RANDOLPH

Ever Disciplined

LastModifiedDate

10/15/2005