MIA ELYSE GOODLY Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004116

License Status

NOT RENEWED

Business

First Name

MIA

Middle

ELYSE

Last Name

GOODLY

Business Name

MIA ELYSE GOODLY

Original Issue Date

08/25/2014

Effective Date

11/19/2015

Expiration Date

12/31/2017

City

TUCSON

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/10/2018