KELLY MARIE SUPATARAPORN - Occupational Therapist License in Illinois | # 056009273

KELLY MARIE SUPATARAPORN

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056009273

License Status

NOT RENEWED

Business

N

First Name

KELLY

Middle

MARIE

Last Name

SUPATARAPORN

Business Name

KELLY MARIE SUPATARAPORN

Original Issue Date

01/27/2011

Effective Date

11/30/2015

Expiration Date

12/31/2017

State

IL

Ever Disciplined

N

LastModifiedDate

04/10/2018