SUSAN R LATTA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000973

License Status

NOT RENEWED

Business

First Name

SUSAN R

Last Name

LATTA

Business Name

SUSAN R LATTA

Original Issue Date

08/08/1984

Effective Date

01/02/2020

Expiration Date

01/31/2022

City

BARTONVILLE

State

Zip

61607

County

PEORIA

Ever Disciplined

LastModifiedDate

05/18/2022