PAUL D GUSTAFSON Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001879

License Status

NOT RENEWED

Business

First Name

PAUL

Middle

Last Name

GUSTAFSON

Business Name

PAUL D GUSTAFSON

Original Issue Date

05/25/1990

Expiration Date

07/20/1991

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/31/2005