KIM E FONNER Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056008777

License Status

ACTIVE

Business

First Name

KIM E

Last Name

FONNER

Business Name

KIM E FONNER

Original Issue Date

08/26/2009

Effective Date

11/17/2025

Expiration Date

12/31/2027

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

11/17/2025