ANDRE DIVINE DOMINGOS - Occupational Therapist License in Maryland | # 057005976

ANDRE DIVINE DOMINGOS

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057005976

License Status

NOT RENEWED

Business

N

First Name

ANDRE

Middle

DIVINE

Last Name

DOMINGOS

Business Name

ANDRE DIVINE DOMINGOS

Original Issue Date

04/10/2023

Effective Date

12/27/2023

Expiration Date

12/31/2025

State

MD

Ever Disciplined

N

LastModifiedDate

04/01/2026