LISA S MIDDLETON Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003043

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

MIDDLETON

Business Name

LISA S MIDDLETON

Original Issue Date

09/10/2004

Effective Date

09/10/2004

Expiration Date

09/10/2005

City

SALEM

State

Zip

62881

County

MARION

Ever Disciplined

LastModifiedDate

05/31/2005