KEVIN R GOODRUM Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001730

License Status

NOT RENEWED

Business

First Name

KEVIN R

Last Name

GOODRUM

Business Name

KEVIN R GOODRUM

Original Issue Date

04/12/1989

Effective Date

01/01/1998

Expiration Date

04/12/1990

City

PETERSBURG

State

Zip

62675

County

MENARD

Ever Disciplined

LastModifiedDate

05/31/2005