JEANIE DEE FOUNTAIN Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005277

License Status

INACTIVE

Business

First Name

JEANIE

Middle

DEE

Last Name

FOUNTAIN

Business Name

JEANIE DEE FOUNTAIN

Original Issue Date

03/09/1999

Effective Date

12/11/2013

Expiration Date

12/31/2015

City

BETTENDORF

State

Zip

52722

County

IOWA

Ever Disciplined

LastModifiedDate

10/15/2015