TIMOTHY S BLYTHE Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044004229

License Status

NOT RENEWED

Business

First Name

TIMOTHY S

Last Name

BLYTHE

Business Name

TIMOTHY S BLYTHE

Original Issue Date

12/16/1991

Effective Date

01/30/2018

Expiration Date

11/30/2019

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

01/23/2020