MITZI R BAKER Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003679

License Status

EXPIRED

Business

First Name

MITZI R

Last Name

BAKER

Business Name

MITZI R BAKER

Original Issue Date

10/05/2012

Effective Date

10/05/2012

Expiration Date

10/05/2013

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/04/2018