LACY GAIL CLARK Nursing Home Administrator License verification

Business Entity

ACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044011402

License Status

ACTIVE

Business

First Name

LACY

Middle

GAIL

Last Name

CLARK

Business Name

LACY GAIL CLARK

Original Issue Date

11/21/2016

Effective Date

11/25/2025

Expiration Date

11/30/2027

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

11/25/2025