TAL BAZ Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056003862

License Status

NOT RENEWED

Business

First Name

TAL

Last Name

BAZ

Business Name

TAL BAZ

Original Issue Date

09/29/1995

Effective Date

12/31/2003

Expiration Date

12/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

02/16/2006