PEGGY KAY DISTAD - Occupational Therapist License in Wisconsin | # 056006047

PEGGY KAY DISTAD

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006047

License Status

NOT RENEWED

Business

N

First Name

PEGGY

Middle

KAY

Last Name

DISTAD

Business Name

PEGGY KAY DISTAD

Original Issue Date

03/16/2001

Effective Date

03/23/2004

Expiration Date

12/31/2005

State

WI

Ever Disciplined

N

LastModifiedDate

02/16/2006