WARREN T JACKSON Nursing Home Administrator License verification

Business Entity

CANCELLED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR TEMPORARY

License Number

045004337

License Status

CANCELLED

Business

First Name

WARREN

Middle

Last Name

JACKSON

Business Name

WARREN T JACKSON

Original Issue Date

03/23/2021

Effective Date

03/23/2022

Expiration Date

03/23/2023

City

VILLA RIDGE

State

Zip

62996

Ever Disciplined

LastModifiedDate

03/23/2021