OAC 173-39-02.12 · Nursing License & Certification Tracking
Dulla Care Home Healthcare
All nursing licenses re-verified annually via the Ohio eLicense Portal · Renewal dates tracked to expiration
10
Total Tracked
0
Verified This Cycle
0
Expiring ≤60 Days
0
Expired
HR Director
Annual Review Period
Log Date
Next Annual Re-Verification
| # | Employee Name | Position | License / Cert Type | License Number | Issuing State | Issue Date | Expiration Date | Days Remaining | Last Verified Date | Next Annual Verification | Verified By | Verification Result | Renewal Submitted? | Renewed Date | Notes | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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| 8 | — | |||||||||||||||
| 9 | — | |||||||||||||||
| 10 | — |
🔗 Ohio eLicense Portal — Annual Re-Verification Protocol
HR Director / Licensure Verifier Signature
Signature & Date
Administrator Approval
Signature & Date
Dulla Care Home Healthcare · Licensure Tracking Log · OAC 173-39-02.12 · Ohio eLicense Portal Annual Re-Verification · Confidential