DOROTHY JEAN MIKUCKI Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044003050

License Status

INACTIVE

Business

First Name

DOROTHY JEAN

Last Name

MIKUCKI

Business Name

DOROTHY JEAN MIKUCKI

Original Issue Date

09/10/1985

Effective Date

01/07/2004

Expiration Date

11/30/2003

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/11/2005