SHAMMONA SHALISA CLARK Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003886

License Status

NOT RENEWED

Business

First Name

SHAMMONA

Middle

SHALISA

Last Name

CLARK

Business Name

SHAMMONA SHALISA CLARK

Original Issue Date

09/29/2015

Effective Date

09/29/2015

Expiration Date

09/29/2016

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

03/09/2017