RONNETTA FAYE SHAKE Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002277

License Status

NOT RENEWED

Business

First Name

RONNETTA

Middle

FAYE

Last Name

SHAKE

Business Name

RONNETTA FAYE SHAKE

Original Issue Date

03/14/2002

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

ODON

State

Zip

47562

County

INDIANA

Ever Disciplined

LastModifiedDate

09/11/2005