KELLY JEAN AMBROSE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001630

License Status

NOT RENEWED

Business

First Name

KELLY JEAN

Last Name

AMBROSE

Business Name

KELLY JEAN AMBROSE

Original Issue Date

05/08/1998

Effective Date

10/06/2017

Expiration Date

12/31/2019

City

ROCKTON

State

Zip

61072

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/05/2020