LILLIAN A BLAKE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043102447

License Status

NOT RENEWED

Business

First Name

LILLIAN

Middle

Last Name

BLAKE

Business Name

LILLIAN A BLAKE

Original Issue Date

10/17/2006

Effective Date

01/14/2009

Expiration Date

01/31/2011

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

03/10/2011