JAMES M FORMAL Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044004919

License Status

NOT RENEWED

Business

First Name

JAMES M

Last Name

FORMAL

Business Name

JAMES M FORMAL

Original Issue Date

06/22/1995

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

WHEATON

State

Zip

60187

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/11/2005