LOIS MAXINE BERGMAN Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002019

License Status

NOT RENEWED

Business

First Name

LOIS

Middle

MAXINE

Last Name

BERGMAN

Business Name

LOIS MAXINE BERGMAN

Original Issue Date

08/19/1991

Expiration Date

09/01/1992

City

RAYMOND

State

Zip

62560

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

05/31/2005