MACY LOGAN LISSIMORE Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057006034

License Status

ACTIVE

Business

First Name

MACY

Middle

LOGAN

Last Name

LISSIMORE

Business Name

MACY LOGAN LISSIMORE

Original Issue Date

08/08/2023

Effective Date

10/06/2025

Expiration Date

12/31/2027

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

10/06/2025