KIM P BLACK Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001551

License Status

NOT RENEWED

Business

First Name

KIM P

Last Name

BLACK

Business Name

KIM P BLACK

Original Issue Date

10/19/1987

Expiration Date

10/01/1988

City

LAKE BLUFF

State

Zip

60044

County

LAKE

Ever Disciplined

LastModifiedDate

05/31/2005