ANN M DERRICK Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044006186

License Status

INACTIVE

Business

First Name

ANN

Middle

Last Name

DERRICK

Business Name

ANN M DERRICK

Original Issue Date

04/14/2003

Effective Date

12/01/2007

Expiration Date

11/30/2009

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/02/2009