NICOLE R MOUNTAIN Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001911

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

MOUNTAIN

Business Name

NICOLE R MOUNTAIN

Original Issue Date

08/14/1990

Expiration Date

08/13/1991

City

PITTSFIELD

State

Zip

62363

County

PIKE

Ever Disciplined

LastModifiedDate

05/31/2005