SELENA LYNNE BANTEL Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056011584

License Status

NOT RENEWED

Business

First Name

SELENA

Middle

LYNNE

Last Name

BANTEL

Business Name

SELENA LYNNE BANTEL

Original Issue Date

07/22/2016

Effective Date

12/20/2017

Expiration Date

12/31/2019

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

03/05/2020