DIANE A WALLACE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000766

License Status

NOT RENEWED

Business

First Name

DIANE A

Last Name

WALLACE

Business Name

DIANE A WALLACE

Original Issue Date

07/17/1984

Expiration Date

12/31/1989

City

CARY

State

Zip

60013

County

MCHENRY

Ever Disciplined

LastModifiedDate

07/28/2005