MARY B ROTH Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000097

License Status

INACTIVE

Business

First Name

MARY B

Last Name

ROTH

Business Name

MARY B ROTH

Original Issue Date

05/01/1984

Effective Date

02/03/2004

Expiration Date

12/31/2003

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005