DOUGLAS S FENNEMA Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044011213

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

FENNEMA

Business Name

DOUGLAS S FENNEMA

Original Issue Date

02/19/2015

Effective Date

11/09/2017

Expiration Date

11/30/2019

City

PLANTATION

State

Zip

33322

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/23/2020