Stacie Earlene Shive
Health Facility Administrator Provisional
Indiana 47000110A Expired
This Indiana license was held by Stacie Earlene Shive. The license is no longer active. It was granted on 12/23/2004 and expired on 06/23/2005
LICENSE DETAILS
- License Number: 47000110A
- Category: HFA Provisional
- Status: Expired
- Date Granted: 12/23/2004 (over 20 years ago)
- Expiry Date: 06/23/2005 (almost 20 years ago)
LOCATIONS
A Address
Bowling Green KY 42104