ERNEST R JACK III Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007628

License Status

ACTIVE

Business

First Name

ERNEST

Middle

Last Name

JACK

Suffix

III

Business Name

ERNEST R JACK III

Original Issue Date

12/12/2005

Effective Date

12/16/2025

Expiration Date

12/31/2027

City

MANHATTAN

State

Zip

60442

County

WILL

Ever Disciplined

LastModifiedDate

12/16/2025