TRACEY LYNNE CAVALLARO Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003699

License Status

NOT RENEWED

Business

First Name

TRACEY

Middle

LYNNE

Last Name

CAVALLARO

Business Name

TRACEY LYNNE CAVALLARO

Original Issue Date

01/23/2013

Effective Date

01/23/2013

Expiration Date

01/23/2014

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

08/12/2014