DAVID L SIMON Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003594

License Status

EXPIRED

Business

First Name

DAVID

Middle

Last Name

SIMON

Business Name

DAVID L SIMON

Original Issue Date

07/27/2011

Effective Date

07/28/2012

Expiration Date

11/22/2012

City

MOUNT CARROLL

State

Zip

61053

County

CARROLL

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/04/2018