MAHLON R DAVID Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044003520

License Status

INACTIVE

Business

First Name

MAHLON R

Last Name

DAVID

Business Name

MAHLON R DAVID

Original Issue Date

04/02/1988

Expiration Date

11/30/1991

City

ROCKFORD

State

Zip

61108

County

KNOX

Ever Disciplined

LastModifiedDate

05/27/2005