Stacey Kathleen Blake
ExpiredCalifornia license 626429
License
- Licensed by
- California Board of Registered Nursing
- License number
- 626429
- Status
- Expired (Delinquent)
- First issued
- September 18, 2003
- Expired
- September 30, 2005
- License holder
- Stacey Kathleen Blake
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
15214 Washington Ave
Lake Elsinore, CA 92530
Lake Elsinore, CA 92530
Riverside County