TRAVIS W LANE - Nursing Home Administrator License in Illinois | # 045004070

TRAVIS W LANE

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004070

License Status

EXPIRED

Business

N

First Name

TRAVIS

Middle

W

Last Name

LANE

Business Name

TRAVIS W LANE

Original Issue Date

11/30/2017

Effective Date

01/03/2019

Expiration Date

01/03/2020

State

IL

Ever Disciplined

N

LastModifiedDate

03/05/2020