MICHAEL J FREDRICKSON Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002526

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

FREDRICKSON

Business Name

MICHAEL J FREDRICKSON

Original Issue Date

07/22/2004

Effective Date

10/17/2019

Expiration Date

01/31/2022

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Ever Disciplined

LastModifiedDate

05/18/2022