THERESA M WALTHALL Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005487

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

Last Name

WALTHALL

Business Name

THERESA M WALTHALL

Original Issue Date

09/21/1999

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

09/11/2005