DAWN M STAMBAUGH Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002878

License Status

CANCELLED

Business

First Name

DAWN

Middle

Last Name

STAMBAUGH

Business Name

DAWN M STAMBAUGH

Original Issue Date

06/26/2002

Effective Date

05/28/2004

Expiration Date

06/26/2003

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

05/31/2005