DIANE M JELLEMA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057000366

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

JELLEMA

Business Name

DIANE M JELLEMA

Original Issue Date

02/27/1986

Effective Date

12/12/2019

Expiration Date

01/31/2022

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

05/18/2022