NICOLE D JACK Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007593

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

JACK

Business Name

NICOLE D JACK

Original Issue Date

11/04/2005

Effective Date

12/19/2025

Expiration Date

12/31/2027

City

MANHATTAN

State

Zip

60442

County

WILL

Ever Disciplined

LastModifiedDate

12/19/2025