STEPHANIE MARIE LANE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004263

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

MARIE

Last Name

LANE

Business Name

STEPHANIE MARIE LANE

Original Issue Date

04/24/2015

Effective Date

12/21/2015

Expiration Date

12/31/2017

City

WOOD RIVER

State

Zip

62095

County

MADISON

Ever Disciplined

LastModifiedDate

04/10/2018