SELENA DIANE GONZALEZ Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005111

License Status

NOT RENEWED

Business

First Name

SELENA

Middle

DIANE

Last Name

GONZALEZ

Business Name

SELENA DIANE GONZALEZ

Original Issue Date

11/12/1998

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

PARK FOREST

State

Zip

60466

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005