SUSAN MARIE SHAW Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044011150

License Status

INACTIVE

Business

First Name

SUSAN

Middle

MARIE

Last Name

SHAW

Business Name

SUSAN MARIE SHAW

Original Issue Date

08/19/2014

Effective Date

12/02/2019

Expiration Date

02/28/2022

City

FAIRBURY

State

Zip

61739

County

COLES

Ever Disciplined

LastModifiedDate

02/28/2022