DOUGLAS R KLASKA Nursing Home Administrator License verification

Business Entity

EXPIRED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004213

License Status

EXPIRED

Business

First Name

DOUGLAS

Middle

Last Name

KLASKA

Business Name

DOUGLAS R KLASKA

Original Issue Date

09/26/2019

Effective Date

11/17/2020

Expiration Date

11/17/2021

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

07/27/2022