SHELLY CHRISTINE FENOLIO Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002059

License Status

INACTIVE

Business

First Name

SHELLY

Middle

CHRISTINE

Last Name

FENOLIO

Business Name

SHELLY CHRISTINE FENOLIO

Original Issue Date

05/18/2000

Effective Date

01/04/2012

Expiration Date

12/31/2013

City

CROWN POINT

State

Zip

46307

County

INDIANA

Ever Disciplined

LastModifiedDate

10/04/2013