SAMANTHA K BLAKE Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044010301

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

BLAKE

Business Name

SAMANTHA K BLAKE

BusinessDBA

SHINN, SHINN-BLAKE

Original Issue Date

12/12/2007

Effective Date

12/12/2007

Expiration Date

11/30/2009

City

DURANT

State

Zip

52747

County

IOWA

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/07/2010