License holder summary

GARY WAYNE PETERSON is a Nursing Home Administrators - Nursing Home Administrator Provisional licensed to practice in Iowa. The address on file for GARY WAYNE PETERSON is 4204 S Magnolia Ave SIOUX FALLS SD 57103. This licensed professional license is not current. The license was granted 11/16/2012 and expired on 02/16/2013.

Iowa

Professional Licensing Bureau

GARY WAYNE PETERSON
Nursing Home Administrators - Nursing Home Administrator Provisional
License number
00950
Date granted
11/16/2012
Date expires
02/16/2013
Class
Nursing Home Administrators - Nursing Home Administrator Provisional
Status
Inactive
Address
4204 S Magnolia Ave SIOUX FALLS SD 57103
iowalicenses.org
ID 24158263
LAST UPDATED 2021-10-25 12:24:44 UTC

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