RUSSELL WAYNE TOLLIVER Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004325

License Status

EXPIRED

Business

First Name

RUSSELL

Middle

WAYNE

Last Name

TOLLIVER

Business Name

RUSSELL WAYNE TOLLIVER

Original Issue Date

01/19/2021

Effective Date

01/19/2021

Expiration Date

01/19/2022

City

WHITE HALL

State

Zip

62092

County

ADAMS

Ever Disciplined

LastModifiedDate

07/27/2022