LACEY ANN MOFFITT Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004300

License Status

CANCELLED

Business

First Name

LACEY

Middle

ANN

Last Name

MOFFITT

Business Name

LACEY ANN MOFFITT

Original Issue Date

10/22/2020

Effective Date

10/22/2020

Expiration Date

10/22/2021

City

AVISTON

State

Zip

62216

County

CLINTON

Ever Disciplined

LastModifiedDate

10/22/2020