KRISTA CAROLYN MARTIN Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057003627

License Status

INACTIVE

Business

First Name

KRISTA

Middle

CAROLYN

Last Name

MARTIN

Business Name

KRISTA CAROLYN MARTIN

Original Issue Date

08/02/2012

Effective Date

08/02/2012

Expiration Date

12/31/2013

City

CHERRY VALLEY

State

Zip

61016

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/04/2013