STACEY SUSANNE BLEICK - Occupational Therapist License in Wisconsin | # 056005881

STACEY SUSANNE BLEICK

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005881

License Status

INACTIVE

Business

N

First Name

STACEY

Middle

SUSANNE

Last Name

BLEICK

Business Name

STACEY SUSANNE BLEICK

Original Issue Date

09/18/2000

Effective Date

12/01/2003

Expiration Date

12/31/2005

State

WI

Ever Disciplined

N

LastModifiedDate

10/25/2005