THERESA CLARK Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057002623

License Status

NOT RENEWED

Business

First Name

THERESA

Last Name

CLARK

Business Name

THERESA CLARK

Original Issue Date

08/11/2005

Effective Date

11/23/2015

Expiration Date

12/31/2017

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

04/10/2018