SANDRA JEAN GOULT Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001643

License Status

NOT RENEWED

Business

First Name

SANDRA JEAN

Last Name

GOULT

Business Name

SANDRA JEAN GOULT

Original Issue Date

05/11/1998

Effective Date

10/25/2005

Expiration Date

12/31/2007

City

LOWELL

State

Zip

46356

County

INDIANA

Ever Disciplined

LastModifiedDate

03/31/2008