GAIL MARIE LEAFBLAD Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002775

License Status

NOT RENEWED

Business

First Name

GAIL

Middle

MARIE

Last Name

LEAFBLAD

Business Name

GAIL MARIE LEAFBLAD

Original Issue Date

11/16/2006

Effective Date

12/07/2009

Expiration Date

12/31/2011

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/08/2012