KATHLEEN PHANOUVONG - Occupational Therapist License in Illinois | # 057004409

KATHLEEN PHANOUVONG

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004409

License Status

NOT RENEWED

Business

N

First Name

KATHLEEN

Last Name

PHANOUVONG

Business Name

KATHLEEN PHANOUVONG

Original Issue Date

11/16/2015

Effective Date

12/16/2021

Expiration Date

12/31/2023

State

IL

Ever Disciplined

N

LastModifiedDate

03/28/2024