GINA FAYE DOUGLASS Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003560

License Status

EXPIRED

Business

First Name

GINA

Middle

FAYE

Last Name

DOUGLASS

Business Name

GINA FAYE DOUGLASS

Original Issue Date

03/07/2011

Effective Date

03/08/2012

Expiration Date

08/23/2012

City

PRAIRIE CITY

State

Zip

61470

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

01/04/2018