JUDENER FONTILUS - Occupational Therapist License in Indiana | # 057004583

JUDENER FONTILUS

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004583

License Status

NOT RENEWED

Business

N

First Name

JUDENER

Last Name

FONTILUS

Business Name

JUDENER FONTILUS

Original Issue Date

07/27/2016

Effective Date

12/09/2019

Expiration Date

01/31/2022

State

IN

Ever Disciplined

N

LastModifiedDate

05/18/2022