PHAEDRA YAMEAN MASHBURN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007304

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60653

County

COOK

Ever Disciplined

LastModifiedDate

02/08/2012