DENNIS THADDEUS DE COSTA Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003432

License Status

EXPIRED

Business

First Name

DENNIS

Middle

THADDEUS

Last Name

DE COSTA

Business Name

DENNIS THADDEUS DE COSTA

Original Issue Date

07/29/2009

Effective Date

07/29/2009

Expiration Date

07/29/2010

City

WHITE BEAR LK

State

Zip

55110

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/04/2018