RUSSELL WAYNE TOLLIVER - Nursing Home Administrator License in Illinois | # 045004325

RUSSELL WAYNE TOLLIVER

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004325

License Status

EXPIRED

Business

N

First Name

RUSSELL

Middle

WAYNE

Last Name

TOLLIVER

Business Name

RUSSELL WAYNE TOLLIVER

Original Issue Date

01/19/2021

Effective Date

01/19/2021

Expiration Date

01/19/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022