SUSAN MARIE SHAW Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003706

License Status

CANCELLED

Business

First Name

SUSAN

Middle

MARIE

Last Name

SHAW

Business Name

SUSAN MARIE SHAW

Original Issue Date

02/11/2013

Effective Date

11/26/2013

Expiration Date

11/26/2014

City

SHELBYVILLE

State

Zip

62565

County

SHELBY

Ever Disciplined

LastModifiedDate

03/13/2015