MALISSA ROSE BLUM Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057005585

License Status

ACTIVE

Business

First Name

MALISSA

Middle

ROSE

Last Name

BLUM

Business Name

MALISSA ROSE BLUM

Original Issue Date

05/12/2021

Effective Date

11/30/2025

Expiration Date

12/31/2027

City

UTICA

State

Zip

61373

County

LA SALLE

Ever Disciplined

LastModifiedDate

11/30/2025