CHAD D BERCK Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002901

License Status

CANCELLED

Business

First Name

CHAD

Middle

Last Name

BERCK

Business Name

CHAD D BERCK

Original Issue Date

10/11/2002

Effective Date

05/28/2004

Expiration Date

10/11/2003

City

PINCKNEYVILLE

State

Zip

62274

County

PERRY

Ever Disciplined

LastModifiedDate

05/31/2005