JENNIFER MARIE BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043104289

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

MARIE

Last Name

BLACK

Business Name

JENNIFER MARIE BLACK

Original Issue Date

09/24/2007

Effective Date

01/25/2011

Expiration Date

01/31/2013

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

03/20/2013