Licensed Provider Check ListLicensed Provider Checklist • October 28th, 2014
License Information License ID#: _ Expiration Date: / / Date you first became licensed: / / Licensed by: ☐State of Nevada ☐Tribe☐Federal Government Program Type Licensed Capacity: (as stated on License) ☐Center☐Family Child Care☐Group Family Child Care☐Head Start (traditional, tribal, migrant or early)☐Pre-K (State-funded program)Accreditation type: Expiration Date: Age Range (ex. 6mo.-2yrs) Capacity forAge Range Total Capacity:
