CAROLYN W BLANK Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006922

License Status

NOT RENEWED

Business

First Name

CAROLYN

Middle

Last Name

BLANK

Business Name

CAROLYN W BLANK

Original Issue Date

08/04/2003

Effective Date

12/20/2013

Expiration Date

12/31/2015

City

CHICAGO

State

Zip

60641

County

COOK

Ever Disciplined

LastModifiedDate

02/08/2016