PETER J BLAZINA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057000125

License Status

NOT RENEWED

Business

First Name

PETER J

Last Name

BLAZINA

Business Name

PETER J BLAZINA

Original Issue Date

08/08/1984

Effective Date

12/31/2003

Expiration Date

12/31/2005

City

PLAINFIELD

State

Zip

60544

County

WILL

Ever Disciplined

LastModifiedDate

02/16/2006