DEBORAH FORMAN EICHTEN - Occupational Therapist License in Illinois | # 056000987

DEBORAH FORMAN EICHTEN

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000987

License Status

INACTIVE

Business

N

First Name

DEBORAH FORMAN

Last Name

EICHTEN

Business Name

DEBORAH FORMAN EICHTEN

Original Issue Date

08/08/1984

Effective Date

01/08/2004

Expiration Date

12/31/2003

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005