KELLY JO CLARK Nursing Home Administrator License verification

Business Entity

ACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044010930

License Status

ACTIVE

Business

First Name

KELLY

Middle

Last Name

CLARK

Business Name

KELLY JO CLARK

Original Issue Date

11/27/2012

Effective Date

10/23/2025

Expiration Date

11/30/2027

City

CASEY

State

Zip

62420

County

CLARK

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

10/23/2025