HEATHER A L BERGMAN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056004981

License Status

NOT RENEWED

Business

First Name

HEATHER A

Middle

Last Name

BERGMAN

Business Name

HEATHER A L BERGMAN

Original Issue Date

08/20/1998

Effective Date

05/18/2000

Expiration Date

12/31/1999

City

FISHERS

State

Zip

46038

County

INDIANA

Ever Disciplined

LastModifiedDate

07/28/2005