TINA R JACKOVICH Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057000568

License Status

INACTIVE

Business

First Name

TINA R

Last Name

JACKOVICH

Business Name

TINA R JACKOVICH

Original Issue Date

03/07/1989

Effective Date

02/05/2004

Expiration Date

12/31/2003

City

FRANKFORT

State

Zip

60423

County

WILL

Ever Disciplined

LastModifiedDate

09/11/2005