Nursing Home Administrator

Please print your new Annual Card on ‘card stock’ or heavy paper. Cut along

the dotted lines and you may wish to have it laminated to better protect the Card.

It is imperative and a *requirement that the Oklahoma State Board of Examiners for Long Term Care Administrators (OSBELTCA) to know your correct employment, residence and mailing addresses at all times. Any time you change your administrative position, employment location or your home address, notify the Board office immediately. You may notify the Board online. The Board must have this information in order to communicate with you and keep you informed of important matters relating to your license.

*OSBELTCA rules state that each administrator shall notify the Board within fifteen (15) days following the relocation of either business or personal mailing address. The Board will assess a late fee of seventy- five dollars ($75.00) for failure to provide current written contact information.

Oklahoma State Board of Examiners

for Long Term Care Administrators

Annual Card Number License Number

16-0133N 2481

Shelly Jean Hilton

is duly licensed to practice as a

Long Term Care Administrator Nursing Home Administrator through 12-31-2016.

Please sign in ink Executive Director

Contact this candidate