TIMOTHY S BLYTHE Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001995

License Status

NOT RENEWED

Business

First Name

TIMOTHY S

Last Name

BLYTHE

Business Name

TIMOTHY S BLYTHE

Original Issue Date

04/22/1991

Expiration Date

04/22/1992

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

05/31/2005