JAMES M FORMAL - Nursing Home Administrator License in Illinois | # 044004919

JAMES M FORMAL

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044004919

License Status

NOT RENEWED

Business

N

First Name

JAMES M

Last Name

FORMAL

Business Name

JAMES M FORMAL

Original Issue Date

06/22/1995

Effective Date

01/14/2004

Expiration Date

11/30/2003

State

IL

Ever Disciplined

N

LastModifiedDate

10/11/2005