NATALIE JO WAGNER Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007812

License Status

NOT RENEWED

Business

First Name

NATALIE

Middle

Last Name

WAGNER

Business Name

NATALIE JO WAGNER

Original Issue Date

07/07/2006

Effective Date

10/31/2011

Expiration Date

12/31/2013

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/19/2014