TRACEY M LONG Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004006

License Status

CANCELLED

Business

First Name

TRACEY

Middle

Last Name

LONG

Business Name

TRACEY M LONG

Original Issue Date

03/01/2017

Effective Date

02/13/2017

Expiration Date

02/13/2018

City

ELIZABETH

State

Zip

61028

County

JO DAVIESS

Ever Disciplined

LastModifiedDate

06/15/2018