AMRIT M JACOB - Nursing Home Administrator License in Illinois | # 045002985

AMRIT M JACOB

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002985

License Status

NOT RENEWED

Business

N

First Name

AMRIT

Middle

M

Last Name

JACOB

Business Name

AMRIT M JACOB

Original Issue Date

12/02/2004

Effective Date

12/02/2004

Expiration Date

12/02/2005

State

IL

Ever Disciplined

N

LastModifiedDate

05/31/2005