JEFFERSON JAMES M LICUP Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007185

License Status

NOT RENEWED

Business

First Name

JEFFERSON

Middle

JAMES M

Last Name

LICUP

Business Name

JEFFERSON JAMES M LICUP

Original Issue Date

05/25/2004

Effective Date

11/12/2015

Expiration Date

12/31/2017

City

BOLINGBROOK

State

Zip

60490

County

WILL

Ever Disciplined

LastModifiedDate

04/10/2018