LACY GAIL CLARK Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003863

License Status

EXPIRED

Business

First Name

LACY

Middle

GAIL

Last Name

CLARK

Business Name

LACY GAIL CLARK

Original Issue Date

08/06/2015

Effective Date

08/06/2016

Expiration Date

08/06/2017

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

01/04/2018