MORRIS FREDRICK FORMAN Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044000595

License Status

INACTIVE

Business

First Name

MORRIS FREDRICK

Last Name

FORMAN

Business Name

MORRIS FREDRICK FORMAN

Expiration Date

11/30/1995

City

AMBOY

State

Zip

61310

County

LEE

Ever Disciplined

LastModifiedDate

05/27/2005