STEPHANIE LEIGH BLOSSOMGAME Occupational Therapist License verification

Business Entity

ACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056009579

License Status

ACTIVE

Business

First Name

STEPHANIE

Middle

LEIGH

Last Name

BLOSSOMGAME

Business Name

STEPHANIE LEIGH BLOSSOMGAME

Original Issue Date

11/03/2011

Effective Date

12/15/2025

Expiration Date

12/31/2027

City

MAPLE GROVE

State

Zip

55311

Ever Disciplined

LastModifiedDate

12/15/2025