BROCK ADAM GORMAN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056009986

License Status

NOT RENEWED

Business

First Name

BROCK

Middle

ADAM

Last Name

GORMAN

Business Name

BROCK ADAM GORMAN

Original Issue Date

12/19/2012

Effective Date

11/02/2015

Expiration Date

12/31/2017

City

CAROL STREAM

State

Zip

60188

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/10/2018