THERESA MARY WAGNER Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056012595

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

MARY

Last Name

WAGNER

Business Name

THERESA MARY WAGNER

Original Issue Date

08/08/2018

Effective Date

12/09/2019

Expiration Date

01/31/2022

City

APO

State

Zip

96326

Ever Disciplined

LastModifiedDate

05/18/2022