BLAIR WAGNER Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044005892

License Status

NOT RENEWED

Business

First Name

BLAIR

Last Name

WAGNER

Business Name

BLAIR WAGNER

Original Issue Date

12/13/2000

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

CLINTON

State

Zip

61727

County

DE WITT

Ever Disciplined

LastModifiedDate

10/11/2005