KIMBERLY ANN STACKOWICZ Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056015314

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

ANN

Last Name

STACKOWICZ

Business Name

KIMBERLY ANN STACKOWICZ

Original Issue Date

02/22/2023

Effective Date

12/08/2023

Expiration Date

12/31/2025

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/02/2025