MATTHEW ADAM BLAKE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041439276

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

ADAM

Last Name

BLAKE

Business Name

MATTHEW ADAM BLAKE

Original Issue Date

03/03/2016

Effective Date

03/26/2018

Expiration Date

09/30/2020

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

01/14/2021