DIXIE D COSTANZA Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044001606

License Status

INACTIVE

Business

First Name

DIXIE D

Last Name

COSTANZA

Business Name

DIXIE D COSTANZA

Original Issue Date

02/07/1977

Effective Date

09/26/2001

Expiration Date

11/30/2001

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/11/2005

Case Number

1998000301

Action

Fine

Discipline Start Date

08/11/1998

Discipline Reason

Failing to provide sufficient proof of required continuing education hours during a Department audit.