JACK R MARTIN Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045001697

License Status

NOT RENEWED

Business

First Name

JACK R

Last Name

MARTIN

Business Name

JACK R MARTIN

Original Issue Date

12/30/1988

Expiration Date

12/30/1989

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Ever Disciplined

LastModifiedDate

05/31/2005