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Form 445104 Home Health, Home Services, Home Nursing Agency Renewal / Change of Ownership Licensure Application - Illinois
What Is Form 445104?
This is a legal form that was released by the Illinois Department of Public Health - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is form 445104?
A: Form 445104 is the Home Health, Home Services, Home Nursing Agency Renewal/Change of Ownership Licensure Application for Illinois.
Q: Who needs to fill out form 445104?
A: Home health, home services, and home nursing agencies in Illinois need to fill out form 445104 for renewal or change of ownership.
Q: What is the purpose of form 445104?
A: Form 445104 is used for the licensure application process for home health, home services, and home nursing agencies in Illinois.
Q: Can form 445104 be used for other types of businesses?
A: No, form 445104 is specifically for the licensure application of home health, home services, and home nursing agencies in Illinois.
Form Details:
- Released on March 1, 2022;
- The latest edition provided by the Illinois Department of Public Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 445104 by clicking the link below or browse more documents and templates provided by the Illinois Department of Public Health.
Download Form 445104 Home Health, Home Services, Home Nursing Agency Renewal / Change of Ownership Licensure Application - Illinois
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