STACEY L PRIDEMORE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002844

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

PRIDEMORE

Business Name

STACEY L PRIDEMORE

Original Issue Date

07/12/2007

Effective Date

12/06/2017

Expiration Date

12/31/2019

City

WAVERLY

State

Zip

62692

County

MORGAN

Ever Disciplined

LastModifiedDate

03/05/2020