KRISTEN ANN BRUNNER Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005902

License Status

NOT RENEWED

Business

First Name

KRISTEN

Middle

ANN

Last Name

BRUNNER

Business Name

KRISTEN ANN BRUNNER

Original Issue Date

10/10/2000

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/11/2005