MICHELLE RAE CLARK Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006972

License Status

INACTIVE

Business

First Name

MICHELLE

Middle

RAE

Last Name

CLARK

Business Name

MICHELLE RAE CLARK

Original Issue Date

09/09/2003

Effective Date

12/15/2003

Expiration Date

12/31/2005

City

GRAND RAPIDS

State

Zip

49544

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/25/2005