BONNY C JACOBS Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056003424

License Status

INACTIVE

Business

First Name

BONNY C

Last Name

JACOBS

Business Name

BONNY C JACOBS

Original Issue Date

06/20/1994

Effective Date

01/30/2004

Expiration Date

12/31/2005

City

FORT WAYNE

State

Zip

46835

County

INDIANA

Ever Disciplined

LastModifiedDate

10/25/2005