DAVID C ZACK Nursing Home Administrator License verification

Business Entity

INACTIVE

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044006084

License Status

INACTIVE

Business

First Name

DAVID

Middle

Last Name

ZACK

Business Name

DAVID C ZACK

Original Issue Date

06/25/2002

Effective Date

12/09/2003

Expiration Date

11/30/2005

City

HERMITAGE

State

Zip

37076

Ever Disciplined

LastModifiedDate

10/11/2005