PAUL D GUSTAFSON - Nursing Home Administrator License in Illinois | # 045001879

PAUL D GUSTAFSON

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001879

License Status

NOT RENEWED

Business

N

First Name

PAUL

Middle

D

Last Name

GUSTAFSON

Business Name

PAUL D GUSTAFSON

Original Issue Date

05/25/1990

Expiration Date

07/20/1991

State

IL

Ever Disciplined

N

LastModifiedDate

05/31/2005