TARA LURAE MANZANO Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006377

License Status

ACTIVE

Business

First Name

TARA

Middle

LURAE

Last Name

MANZANO

Business Name

TARA LURAE MANZANO

Original Issue Date

11/29/2001

Effective Date

12/16/2025

Expiration Date

12/31/2027

City

CARBONDALE

State

Zip

62902

County

JACKSON

Ever Disciplined

LastModifiedDate

12/16/2025