KENNIS HAL WALLACE JR Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044002204

License Status

INACTIVE

Business

First Name

KENNIS

Middle

HAL

Last Name

WALLACE

Suffix

Business Name

KENNIS HAL WALLACE JR

Original Issue Date

06/16/1980

Expiration Date

11/30/1989

City

HARRISBURG

State

Zip

62946

County

SALINE

Ever Disciplined

LastModifiedDate

05/27/2005

Case Number

1989004436

Action

Probation

Discipline Start Date

09/01/1989

Discipline End Date

08/31/1992