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Form LG02-B FOR LGHIB USE ONLY LOCAL GOVERNMENT HEALTH

Form LG02-B FOR LGHIB USE ONLY LOCAL GOVERNMENT HEALTH 2025

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4.8 out of 5

140 votes

The document is an application form for individuals seeking appointment to the Board of Nursing Home Administration in Nebraska, specifically for a proprietary home member. It requires personal information, eligibility verification regarding nursing home administrator licensing and experience, education details, work history, and additional information about the applicant's interest in serving on the board. The form also includes questions about potential conflicts of interest and previous disciplinary actions.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (140 Votes)

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