PHAEDRA YAMEAN MASHBURN - Occupational Therapist License in Illinois | # 056007304

PHAEDRA YAMEAN MASHBURN

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007304

License Status

NOT RENEWED

Business

N

First Name

PHAEDRA

Middle

YAMEAN

Last Name

MASHBURN

Business Name

PHAEDRA YAMEAN MASHBURN

Original Issue Date

10/12/2004

Effective Date

03/03/2010

Expiration Date

12/31/2011

State

IL

Ever Disciplined

N

LastModifiedDate

02/08/2012