JEFFREY WILLIAM PETERSEN Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003424

License Status

EXPIRED

Business

First Name

JEFFREY

Middle

WILLIAM

Last Name

PETERSEN

Business Name

JEFFREY WILLIAM PETERSEN

Original Issue Date

06/17/2009

Effective Date

06/17/2009

Expiration Date

06/17/2010

City

WATSEKA

State

Zip

60970

County

IROQUOIS

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/04/2018