GLENN R BLACKLOCK Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044005176

License Status

NOT RENEWED

Business

First Name

GLENN R

Last Name

BLACKLOCK

Business Name

GLENN R BLACKLOCK

Original Issue Date

09/12/1996

Effective Date

11/23/2015

Expiration Date

11/30/2017

City

MORRISON

State

Zip

61270

County

WHITESIDE

Ever Disciplined

LastModifiedDate

01/04/2018