KELLY ANN BLACK - Occupational Therapist License in North Carolina | # 056009759

KELLY ANN BLACK

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056009759

License Status

NOT RENEWED

Business

N

First Name

KELLY

Middle

ANN

Last Name

BLACK

Business Name

KELLY ANN BLACK

Original Issue Date

05/18/2012

Effective Date

12/30/2019

Expiration Date

01/31/2022

State

NC

Ever Disciplined

N

LastModifiedDate

05/18/2022