KELLY D MARTIN Nursing Home Administrator License verification

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044005625

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

MARTIN

Business Name

KELLY D MARTIN

Original Issue Date

03/19/1999

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

FENTON

State

Zip

63026

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/11/2005