DENNIS L BLOM Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044001164

License Status

NOT RENEWED

Business

First Name

DENNIS L

Last Name

BLOM

Business Name

DENNIS L BLOM

Original Issue Date

09/27/1974

Expiration Date

11/30/1985

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

05/27/2005