GARY T JOHANSON - Nursing Home Administrator License in Illinois | # 044002218

GARY T JOHANSON

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044002218

License Status

NOT RENEWED

Business

N

First Name

GARY T

Last Name

JOHANSON

Business Name

GARY T JOHANSON

Original Issue Date

06/16/1980

Effective Date

01/14/2004

Expiration Date

11/30/2003

State

IL

Ever Disciplined

N

LastModifiedDate

10/11/2005