ALISHA R BLAYLOCK Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044006266

License Status

INACTIVE

Business

First Name

ALISHA

Middle

Last Name

BLAYLOCK

Business Name

ALISHA R BLAYLOCK

Original Issue Date

01/06/2004

Effective Date

11/18/2009

Expiration Date

11/30/2011

City

PLAINFIELD

State

Zip

60585

County

WILL

Ever Disciplined

LastModifiedDate

09/07/2011