SAMANTHA A BANEY Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045003890

License Status

CANCELLED

Business

First Name

SAMANTHA

Middle

Last Name

BANEY

Business Name

SAMANTHA A BANEY

Original Issue Date

10/08/2015

Effective Date

10/08/2015

Expiration Date

10/08/2016

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/08/2015