LORI JO BOUTELLE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005278

License Status

NOT RENEWED

Business

First Name

LORI

Middle

Last Name

BOUTELLE

Business Name

LORI JO BOUTELLE

Original Issue Date

03/11/1999

Effective Date

12/30/2003

Expiration Date

12/31/2005

City

LAKE VILLA

State

Zip

60046

County

LAKE

Ever Disciplined

LastModifiedDate

02/16/2006