MARY LOU WILD Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044005471

License Status

INACTIVE

Business

First Name

MARY

Middle

LOU

Last Name

WILD

Business Name

MARY LOU WILD

Original Issue Date

07/06/1998

Effective Date

11/26/2003

Expiration Date

11/30/2003

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/11/2005