SHAVONTAE SHATRICE WILSON Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004490

License Status

ACTIVE

Business

First Name

SHAVONTAE

Middle

SHATRICE

Last Name

WILSON

Business Name

SHAVONTAE SHATRICE WILSON

Original Issue Date

03/29/2016

Effective Date

10/02/2025

Expiration Date

12/31/2027

City

DAVENPORT

State

Zip

52804

Ever Disciplined

LastModifiedDate

10/02/2025