ELIZABETH C BLAKE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043088261

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

Last Name

BLAKE

Business Name

ELIZABETH C BLAKE

Original Issue Date

02/05/2003

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

MAKANDA

State

Zip

62958

County

JACKSON

Ever Disciplined

LastModifiedDate

10/21/2005