SUSAN GAIL BLACKWOOD Respiratory Care Practitioner License verification

Business Entity

INACTIVE

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194004695

License Status

INACTIVE

Business

First Name

SUSAN

Middle

GAIL

Last Name

BLACKWOOD

Business Name

SUSAN GAIL BLACKWOOD

Original Issue Date

04/12/2001

Effective Date

11/01/2005

Expiration Date

10/31/2007

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

08/07/2007