VICKI J CLARK Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044006071

License Status

NOT RENEWED

Business

First Name

VICKI

Middle

Last Name

CLARK

Business Name

VICKI J CLARK

Original Issue Date

06/05/2002

Effective Date

11/24/2003

Expiration Date

11/30/2005

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

01/09/2006