MARY R BLAHA Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002053

License Status

NOT RENEWED

Business

First Name

MARY R

Last Name

BLAHA

Business Name

MARY R BLAHA

Original Issue Date

12/18/1991

Expiration Date

12/18/1992

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/31/2005