ANTIGONE DAWN BLACKWELL - Occupational Therapist License in Illinois | # 056005060

ANTIGONE DAWN BLACKWELL

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005060

License Status

NOT RENEWED

Business

N

First Name

ANTIGONE

Middle

DAWN

Last Name

BLACKWELL

Business Name

ANTIGONE DAWN BLACKWELL

Original Issue Date

11/10/1998

Effective Date

05/18/2000

Expiration Date

12/31/1999

State

IL

Ever Disciplined

N

LastModifiedDate

07/28/2005