DIANE A WALLACE - Occupational Therapist License in Illinois | # 056000766

DIANE A WALLACE

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000766

License Status

NOT RENEWED

Business

N

First Name

DIANE A

Last Name

WALLACE

Business Name

DIANE A WALLACE

Original Issue Date

07/17/1984

Expiration Date

12/31/1989

State

IL

Ever Disciplined

N

LastModifiedDate

07/28/2005