GRACE C WASTAK Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044001848

License Status

INACTIVE

Business

First Name

GRACE C

Last Name

WASTAK

Business Name

GRACE C WASTAK

Original Issue Date

02/28/1978

Effective Date

11/20/2003

Expiration Date

11/30/2003

City

CHICAGO

State

Zip

60629

County

COOK

Ever Disciplined

LastModifiedDate

10/11/2005