LISA MARIE HENNIN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004005

License Status

NOT RENEWED

Business

First Name

LISA

Middle

MARIE

Last Name

HENNIN

Business Name

LISA MARIE HENNIN

Original Issue Date

03/19/2014

Effective Date

12/27/2017

Expiration Date

12/31/2019

City

FAIR OAKS

State

Zip

47943

County

INDIANA

Ever Disciplined

LastModifiedDate

03/05/2020