DOUGLAS D CARLSON Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002251

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

CARLSON

Business Name

DOUGLAS D CARLSON

Original Issue Date

08/08/1994

Expiration Date

08/05/1995

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/31/2005