SHANE TOD BURGESS Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002001

License Status

ACTIVE

Business

First Name

SHANE

Middle

TOD

Last Name

BURGESS

Business Name

SHANE TOD BURGESS

Original Issue Date

05/18/2000

Effective Date

12/28/2025

Expiration Date

12/31/2027

City

ALTAMONT

State

Zip

62411

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

12/28/2025