JACOB DONIVAN PELOQUIN - Occupational Therapist License in Wisconsin | # 056008205

JACOB DONIVAN PELOQUIN

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056008205

License Status

NOT RENEWED

Business

N

First Name

JACOB

Middle

DONIVAN

Last Name

PELOQUIN

Business Name

JACOB DONIVAN PELOQUIN

Original Issue Date

11/08/2007

Effective Date

12/21/2009

Expiration Date

12/31/2011

State

WI

Ever Disciplined

N

LastModifiedDate

02/08/2012