JACQUE L FORD Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001331

License Status

ACTIVE

Business

First Name

JACQUE L

Last Name

FORD

Business Name

JACQUE L FORD

Original Issue Date

09/11/1996

Effective Date

12/17/2025

Expiration Date

12/31/2027

City

DU QUOIN

State

Zip

62832

County

PERRY

Ever Disciplined

LastModifiedDate

12/17/2025