NICHOLAS TYLER PEACOCK Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057005500

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

TYLER

Last Name

PEACOCK

Business Name

NICHOLAS TYLER PEACOCK

Original Issue Date

11/06/2020

Effective Date

12/18/2021

Expiration Date

12/31/2023

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

03/28/2024