TIMOTHY J BOISSEAU Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044003624

License Status

NOT RENEWED

Business

First Name

TIMOTHY J

Last Name

BOISSEAU

Business Name

TIMOTHY J BOISSEAU

Original Issue Date

12/27/1988

Effective Date

11/20/2017

Expiration Date

11/30/2019

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

01/23/2020