GLENN R BLACKLOCK - Nursing Home Administrator License in Illinois | # 045002354

GLENN R BLACKLOCK

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002354

License Status

NOT RENEWED

Business

N

First Name

GLENN R

Last Name

BLACKLOCK

Business Name

GLENN R BLACKLOCK

Original Issue Date

11/21/1995

Expiration Date

09/18/1996

State

IL

Ever Disciplined

N

LastModifiedDate

05/31/2005