ANGELA MARIE DAVAULT Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007386

License Status

INACTIVE

Business

First Name

ANGELA

Middle

MARIE

Last Name

DAVAULT

Business Name

ANGELA MARIE DAVAULT

Original Issue Date

03/09/2005

Effective Date

10/06/2017

Expiration Date

12/31/2019

City

MANTENO

State

Zip

60950

County

KANKAKEE

Ever Disciplined

LastModifiedDate

10/02/2019