SHELBY NICOLE WAGNER Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057003901

License Status

NOT RENEWED

Business

First Name

SHELBY

Middle

NICOLE

Last Name

WAGNER

Business Name

SHELBY NICOLE WAGNER

Original Issue Date

09/05/2013

Effective Date

12/21/2021

Expiration Date

12/31/2023

City

NEWTON

State

Zip

62448

County

JASPER

Ever Disciplined

LastModifiedDate

03/28/2024