DIANN BLACK Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044004046

License Status

INACTIVE

Business

First Name

DIANN

Last Name

BLACK

Business Name

DIANN BLACK

Original Issue Date

01/15/1991

Effective Date

11/26/2013

Expiration Date

11/30/2015

City

WEST SALEM

State

Zip

62476

County

WABASH

Ever Disciplined

LastModifiedDate

09/04/2015