DOUGLAS GILLEN FOSCO Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056009640

License Status

INACTIVE

Business

First Name

DOUGLAS

Middle

GILLEN

Last Name

FOSCO

Business Name

DOUGLAS GILLEN FOSCO

Original Issue Date

02/02/2012

Effective Date

10/16/2017

Expiration Date

12/31/2019

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

10/02/2019