SALLY ANN CARLQUIST Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000263

License Status

NOT RENEWED

Business

First Name

SALLY ANN

Last Name

CARLQUIST

Business Name

SALLY ANN CARLQUIST

Original Issue Date

05/16/1984

Expiration Date

12/31/1985

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/28/2005