MELISSA R BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043089425

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

Last Name

BLACK

Business Name

MELISSA R BLACK

Original Issue Date

12/30/2003

Effective Date

06/30/2015

Expiration Date

01/31/2017

City

URSA

State

Zip

62376

County

ADAMS

Ever Disciplined

LastModifiedDate

03/27/2017