TERRY A FONG Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007140

License Status

NOT RENEWED

Business

First Name

TERRY

Middle

Last Name

FONG

Business Name

TERRY A FONG

Original Issue Date

04/08/2004

Effective Date

11/23/2009

Expiration Date

12/31/2011

City

SCOTTSDALE

State

Zip

85251

County

ARIZONA

Ever Disciplined

LastModifiedDate

02/08/2012