TRACY M WIGGENHORN Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002228

License Status

NOT RENEWED

Business

First Name

TRACY M

Last Name

WIGGENHORN

Business Name

TRACY M WIGGENHORN

Original Issue Date

05/09/1994

Expiration Date

04/15/1995

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

05/31/2005