SR M JACQUELINE WAGNER Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044001365

License Status

NOT RENEWED

Business

First Name

SR M JACQUELINE

Last Name

WAGNER

Business Name

SR M JACQUELINE WAGNER

Original Issue Date

09/25/1975

Effective Date

11/05/2015

Expiration Date

11/30/2017

City

DAVENPORT

State

Zip

52807

County

IOWA

Ever Disciplined

LastModifiedDate

01/04/2018