KIM ILEANA JACOBS - Occupational Therapist License in Wisconsin | # 056006729

KIM ILEANA JACOBS

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006729

License Status

NOT RENEWED

Business

N

First Name

KIM

Middle

ILEANA

Last Name

JACOBS

Business Name

KIM ILEANA JACOBS

Original Issue Date

11/13/2002

Effective Date

10/25/2005

Expiration Date

12/31/2007

State

WI

Ever Disciplined

N

LastModifiedDate

02/15/2008