PHYLLIS A SMITH Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002369

License Status

NOT RENEWED

Business

First Name

PHYLLIS A

Last Name

SMITH

Business Name

PHYLLIS A SMITH

Original Issue Date

02/23/1996

Expiration Date

02/09/1997

City

WEST FRANKFORT

State

Zip

62896

County

FRANKLIN

Ever Disciplined

LastModifiedDate

05/31/2005