GIDGET DALE BLACK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043083172

License Status

NOT RENEWED

Business

First Name

GIDGET

Middle

DALE

Last Name

BLACK

Business Name

GIDGET DALE BLACK

Original Issue Date

12/02/1998

Effective Date

03/04/2003

Expiration Date

01/31/2003

City

MOROCCO

State

Zip

47963

County

INDIANA

Ever Disciplined

LastModifiedDate

10/15/2005