SHEILA FORREST WAGNER Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056004524

License Status

NOT RENEWED

Business

First Name

SHEILA FORREST

Last Name

WAGNER

Business Name

SHEILA FORREST WAGNER

Original Issue Date

07/24/1997

Effective Date

12/04/2017

Expiration Date

12/31/2019

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

03/05/2020