TERRY A FONG - Occupational Therapist License in Arizona | # 056007140

TERRY A FONG

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007140

License Status

NOT RENEWED

Business

N

First Name

TERRY

Middle

A

Last Name

FONG

Business Name

TERRY A FONG

Original Issue Date

04/08/2004

Effective Date

11/23/2009

Expiration Date

12/31/2011

State

AZ

Ever Disciplined

N

LastModifiedDate

02/08/2012