KERYL LYNN BLAYLOCK Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004388

License Status

NOT RENEWED

Business

First Name

KERYL

Middle

LYNN

Last Name

BLAYLOCK

Business Name

KERYL LYNN BLAYLOCK

Original Issue Date

09/23/2015

Effective Date

12/15/2015

Expiration Date

12/31/2017

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

04/10/2018