§2060.211. License Application Forms

a)         An application for a license, an application to renew a license, an application to relocate a facility or an application to add an additional level of care or category (adolescent/adult) shall be made on forms specified by the Department.  The organization shall provide any and all information requested on the application forms.

 

b)         Such forms may be obtained in person or by writing to:

 

            Illinois Department of Human Services

            Office of Alcoholism and Substance Abuse

            100 W. Randolph St., Suite 5-600

            Chicago, Illinois 60601

            Attention: Division of Licensing and Certification

 

c)         An application for a license shall be signed and dated by the organization representative, and at least two of the corporate officers in the case of a corporate applicant, or by all partners or associates in the case of a partnership or association.

 

(Source:  Amended at 25 Ill. Reg. 11063, effective August 14, 2001)