KIM P BLACK Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044003590

License Status

INACTIVE

Business

First Name

KIM P

Last Name

BLACK

Business Name

KIM P BLACK

Original Issue Date

01/14/1989

Expiration Date

11/30/1989

City

LAKE BLUFF

State

Zip

60044

County

LAKE

Ever Disciplined

LastModifiedDate

05/27/2005