SUE ELLEN KLARK - Occupational Therapist License in Illinois | # 057000030

SUE ELLEN KLARK

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057000030

License Status

NOT RENEWED

Business

N

First Name

SUE ELLEN

Last Name

KLARK

Business Name

SUE ELLEN KLARK

Original Issue Date

05/16/1984

Effective Date

10/10/2007

Expiration Date

12/31/2009

State

IL

Ever Disciplined

N

LastModifiedDate

02/04/2010