AMY L BONTA Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002924

License Status

CANCELLED

Business

First Name

AMY

Middle

Last Name

BONTA

Business Name

AMY L BONTA

Original Issue Date

01/30/2003

Effective Date

05/28/2004

Expiration Date

01/30/2004

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/31/2005