KELLY JO CLARK Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003551

License Status

EXPIRED

Business

First Name

KELLY

Middle

Last Name

CLARK

Business Name

KELLY JO CLARK

Original Issue Date

01/19/2011

Effective Date

01/19/2011

Expiration Date

05/24/2012

City

CASEY

State

Zip

62420

County

CLARK

Specialty/Qualifier

NON LIMITED

Ever Disciplined

LastModifiedDate

09/09/2025

Case Number

2023002834

Action

Reprimand

Discipline Start Date

09/03/2025