AMY M BLAKE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005350

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

BLAKE

Business Name

AMY M BLAKE

Original Issue Date

05/17/1999

Effective Date

01/02/2022

Expiration Date

12/31/2023

City

MT CARMEL

State

Zip

62863

County

WABASH

Ever Disciplined

LastModifiedDate

03/28/2024