DIANE MARIE JACKSON Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056009479

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

MARIE

Last Name

JACKSON

Business Name

DIANE MARIE JACKSON

Original Issue Date

09/01/2011

Effective Date

10/06/2017

Expiration Date

12/31/2019

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

03/05/2020