LOU C BLACK Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044006170

License Status

NOT RENEWED

Business

First Name

LOU

Middle

Last Name

BLACK

Business Name

LOU C BLACK

Original Issue Date

03/20/2003

Effective Date

10/16/2003

Expiration Date

11/30/2005

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Ever Disciplined

LastModifiedDate

01/09/2006