MARK A BERG Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002855

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

BERG

Business Name

MARK A BERG

Original Issue Date

04/08/2002

Effective Date

06/13/2002

Expiration Date

04/08/2002

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/11/2005