CHIVVON OCTAVIA BONILLA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057004053

License Status

NOT RENEWED

Business

First Name

CHIVVON

Middle

OCTAVIA

Last Name

BONILLA

Business Name

CHIVVON OCTAVIA BONILLA

Original Issue Date

05/27/2014

Effective Date

05/27/2014

Expiration Date

12/31/2015

City

GARY

State

Zip

46409

County

INDIANA

Ever Disciplined

LastModifiedDate

02/08/2016