DEBORAH FORMAN EICHTEN Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056000987

License Status

INACTIVE

Business

First Name

DEBORAH FORMAN

Last Name

EICHTEN

Business Name

DEBORAH FORMAN EICHTEN

Original Issue Date

08/08/1984

Effective Date

01/08/2004

Expiration Date

12/31/2003

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005