GARY E LARSON Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002303

License Status

NOT RENEWED

Business

First Name

GARY E

Last Name

LARSON

Business Name

GARY E LARSON

Original Issue Date

04/06/1995

Expiration Date

04/05/1996

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/31/2005