SUE ELLEN KLARK Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057000030

License Status

NOT RENEWED

Business

First Name

SUE ELLEN

Last Name

KLARK

Business Name

SUE ELLEN KLARK

Original Issue Date

05/16/1984

Effective Date

10/10/2007

Expiration Date

12/31/2009

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

02/04/2010