STACEY WALLACE Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056015976

License Status

ACTIVE

Business

First Name

STACEY

Last Name

WALLACE

Business Name

STACEY WALLACE

Original Issue Date

03/24/2024

Effective Date

03/24/2024

Expiration Date

12/31/2025

City

SAGINAW

State

Zip

48602

Ever Disciplined

LastModifiedDate

10/02/2025