NICOLE MARIE SLACK Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056007779

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

MARIE

Last Name

SLACK

Business Name

NICOLE MARIE SLACK

Original Issue Date

05/11/2006

Effective Date

10/10/2007

Expiration Date

12/31/2009

City

KALAMAZOO

State

Zip

49004

County

MICHIGAN

Ever Disciplined

LastModifiedDate

02/04/2010