SUSANNE R RANDALL Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000469

License Status

INACTIVE

Business

First Name

SUSANNE R

Last Name

RANDALL

Business Name

SUSANNE R RANDALL

Original Issue Date

06/11/1984

Effective Date

11/03/2009

Expiration Date

12/31/2011

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

10/05/2011