MAKEESA SHALAE MONTGOMERY - Occupational Therapist License in Idaho | # 057006166

MAKEESA SHALAE MONTGOMERY

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057006166

License Status

NOT RENEWED

Business

N

First Name

MAKEESA

Middle

SHALAE

Last Name

MONTGOMERY

Business Name

MAKEESA SHALAE MONTGOMERY

Original Issue Date

08/27/2024

Effective Date

08/27/2024

Expiration Date

12/31/2025

State

ID

Ever Disciplined

N

LastModifiedDate

04/01/2026