POLLY LYNN WALLACE Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005734

License Status

ACTIVE

Business

First Name

POLLY

Middle

LYNN

Last Name

WALLACE

Business Name

POLLY LYNN WALLACE

Original Issue Date

05/17/2000

Effective Date

11/26/2025

Expiration Date

12/31/2027

City

LOVES PARK

State

Zip

61111

Ever Disciplined

LastModifiedDate

11/26/2025