SHANNON LEE LANE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057003012

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

LEE

Last Name

LANE

Business Name

SHANNON LEE LANE

Original Issue Date

08/12/2008

Effective Date

04/10/2014

Expiration Date

12/31/2015

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

02/08/2016