TIFFANY R GREEN Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003767

License Status

CANCELLED

Business

First Name

TIFFANY

Middle

Last Name

GREEN

Business Name

TIFFANY R GREEN

Original Issue Date

12/30/2013

Effective Date

12/30/2013

Expiration Date

12/30/2014

City

PERU

State

Zip

61354

County

LA SALLE

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

03/13/2015