JODIE LEE BLACK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041188583

License Status

INACTIVE

Business

First Name

JODIE LEE

Last Name

BLACK

Business Name

JODIE LEE BLACK

Original Issue Date

06/06/1979

Effective Date

06/06/1979

City

APPLETON

State

Zip

54911

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/27/2006