BLAIR WAGNER - Nursing Home Administrator License in Illinois | # 044005892

BLAIR WAGNER

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044005892

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/11/2005