NICOLE R GREEN Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001604

License Status

INACTIVE

Business

First Name

NICOLE R

Last Name

GREEN

Business Name

NICOLE R GREEN

Original Issue Date

12/29/1997

Effective Date

12/01/2003

Expiration Date

12/31/2005

City

MARION

State

Zip

52302

County

LAKE

Ever Disciplined

LastModifiedDate

10/25/2005