JERRYDINE EDMOND MATHIS Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056001470

License Status

INACTIVE

Business

First Name

JERRYDINE EDMOND

Last Name

MATHIS

Business Name

JERRYDINE EDMOND MATHIS

Original Issue Date

02/27/1986

Expiration Date

12/31/1987

City

GARY

State

Zip

46406

County

INDIANA

Ever Disciplined

LastModifiedDate

07/28/2005