PAMELA JO LONG Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002064

License Status

NOT RENEWED

Business

First Name

PAMELA

Middle

Last Name

LONG

Business Name

PAMELA JO LONG

Original Issue Date

05/23/2000

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/11/2005