KAITLYN LEANNE MARIE FORNEK Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056013612

License Status

ACTIVE

Business

First Name

KAITLYN

Middle

LEANNE MARIE

Last Name

FORNEK

Business Name

KAITLYN LEANNE MARIE FORNEK

Original Issue Date

05/15/2020

Effective Date

12/04/2025

Expiration Date

12/31/2027

City

BETTENDORF

State

Zip

52722

Ever Disciplined

LastModifiedDate

12/04/2025