ELIZABETH MEDINA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001660

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Last Name

MEDINA

Business Name

ELIZABETH MEDINA

Original Issue Date

05/12/1998

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

CROWN POINT

State

Zip

46307

County

INDIANA

Ever Disciplined

LastModifiedDate

09/11/2005