MARK BLACK Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001435

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

BLACK

Business Name

MARK BLACK

Original Issue Date

09/19/1986

Expiration Date

08/14/1987

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

05/31/2005