LOU C BLACK Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045002934

License Status

CANCELLED

Business

First Name

LOU

Middle

Last Name

BLACK

Business Name

LOU C BLACK

Original Issue Date

03/18/2003

Effective Date

05/28/2004

Expiration Date

03/18/2004

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Ever Disciplined

LastModifiedDate

05/31/2005