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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | William Nathaniel Dale | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | William | [sources] | |||
| Last name | Dale | [sources] | |||
| Middle name | Nathaniel | [sources] | |||
| Sector | Other Non-Traditional-Individual | [sources] | |||
| Address | 744 HAWTHORNE ST, CLOQUET, MN 55720 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended or terminated from Minnesota Health Care Programs.
United States · MHCP
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | Medicare Medicaid exclusion · Minnesota Health Care Programs | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 744 HAWTHORNE ST, CLOQUET, MN 55720 | United States | |