TARA L MOORE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001576

License Status

NOT RENEWED

Business

First Name

TARA L

Last Name

MOORE

Business Name

TARA L MOORE

Original Issue Date

11/12/1997

Effective Date

02/20/2004

Expiration Date

12/31/2005

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

06/13/2019