REBECCA ANN REQUARTH Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056011089

License Status

NOT RENEWED

Business

First Name

REBECCA

Middle

ANN

Last Name

REQUARTH

Business Name

REBECCA ANN REQUARTH

Original Issue Date

08/06/2015

Effective Date

12/09/2015

Expiration Date

12/31/2017

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/10/2018