MARY ANN SMITH Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044010054

License Status

NOT RENEWED

Business

First Name

MARY

Middle

ANN

Last Name

SMITH

Business Name

MARY ANN SMITH

Original Issue Date

12/27/2005

Effective Date

09/07/2017

Expiration Date

11/30/2019

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/23/2020