BERTHA DENISE MIZE-JACKSON Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004543

License Status

EXPIRED

Business

First Name

BERTHA

Middle

DENISE

Last Name

MIZE-JACKSON

Business Name

BERTHA DENISE MIZE-JACKSON

Original Issue Date

07/20/2023

Effective Date

07/20/2023

Expiration Date

07/20/2024

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

12/30/2024