ROBERTA L BENNER - Occupational Therapist License in Wisconsin | # 057003688

ROBERTA L BENNER

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057003688

License Status

INACTIVE

Business

N

First Name

ROBERTA

Middle

L

Last Name

BENNER

Business Name

ROBERTA L BENNER

Original Issue Date

10/30/2012

Effective Date

10/30/2012

Expiration Date

12/31/2013

State

WI

Ever Disciplined

N

LastModifiedDate

10/04/2013