MARTHA G THEISEN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056002715

License Status

NOT RENEWED

Business

First Name

MARTHA G

Last Name

THEISEN

Business Name

MARTHA G THEISEN

Original Issue Date

09/12/1991

Expiration Date

12/31/1995

City

PRAIRIE VIEW

State

Zip

60069

County

LAKE

Ever Disciplined

LastModifiedDate

07/28/2005