LOIS MAXINE BERGMAN Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044004370

License Status

INACTIVE

Business

First Name

LOIS

Middle

MAXINE

Last Name

BERGMAN

Business Name

LOIS MAXINE BERGMAN

Original Issue Date

08/31/1992

Effective Date

09/16/2019

Expiration Date

02/28/2022

City

RAYMOND

State

Zip

62560

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

11/23/2021