PHYLLIS LYNN KOCH Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044003912

License Status

NOT RENEWED

Business

First Name

PHYLLIS LYNN

Last Name

KOCH

Business Name

PHYLLIS LYNN KOCH

Original Issue Date

07/19/1990

Expiration Date

11/30/1991

City

METROPOLIS

State

Zip

62960

County

MASSAC

Ever Disciplined

LastModifiedDate

05/27/2005