HOLLY SUSANNE MONTGOMERY Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007835

License Status

NOT RENEWED

Business

First Name

HOLLY

Middle

SUSANNE

Last Name

MONTGOMERY

Business Name

HOLLY SUSANNE MONTGOMERY

Original Issue Date

08/08/2006

Effective Date

10/10/2007

Expiration Date

12/31/2009

City

DU QUOIN

State

Zip

62832

County

PERRY

Ever Disciplined

LastModifiedDate

02/04/2010