DOROTHY LOUISE EIDEM Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001752

License Status

INACTIVE

Business

First Name

DOROTHY

Middle

LOUISE

Last Name

EIDEM

Business Name

DOROTHY LOUISE EIDEM

Original Issue Date

10/27/1998

Effective Date

01/06/2004

Expiration Date

12/31/2005

City

EVANS

State

Zip

80620

County

COLORADO

Ever Disciplined

LastModifiedDate

10/25/2005