LISA ANN CLARK Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044010403

License Status

NOT RENEWED

Business

First Name

LISA

Middle

ANN

Last Name

CLARK

Business Name

LISA ANN CLARK

Original Issue Date

10/30/2008

Effective Date

09/14/2009

Expiration Date

11/30/2011

City

WHITE HALL

State

Zip

62092

County

GREENE

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

01/05/2012