NATHAN BENJAMIN FATHAUER Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056013406

License Status

ACTIVE

Business

First Name

NATHAN

Middle

BENJAMIN

Last Name

FATHAUER

Business Name

NATHAN BENJAMIN FATHAUER

Original Issue Date

12/23/2019

Effective Date

12/25/2025

Expiration Date

12/31/2027

City

OGDEN

State

Zip

61859

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

12/25/2025