JENNIFER D BLAYLOCK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043083936

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

BLAYLOCK

Business Name

JENNIFER D BLAYLOCK

Original Issue Date

08/19/1999

Effective Date

01/07/2005

Expiration Date

01/31/2007

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

03/16/2007