HEATHER M EVANS Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006720

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

EVANS

Business Name

HEATHER M EVANS

Original Issue Date

10/30/2002

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

FORT WAYNE

State

Zip

46804

County

INDIANA

Ever Disciplined

LastModifiedDate

09/11/2005