William Randall Provence
InactiveIllinois license 044003095
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 044003095
- Status
- Inactive
- First issued
- October 31, 1985
- Expired
- November 30, 2015
- License holder
- William Randall Provence
- Entity type
- Individual
Classifications
- Licensed Nursing Home Administrator Other Health Care
More from the license record
- Current term began
- 10/07/2013
Contact
Dwight, IL 60420
Livingston County