TAKAKO NISHIYAMA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056004852

License Status

NOT RENEWED

Business

First Name

TAKAKO

Last Name

NISHIYAMA

Business Name

TAKAKO NISHIYAMA

Original Issue Date

05/06/1998

Effective Date

05/18/2000

Expiration Date

12/31/1999

City

ST LOUIS

State

Zip

63130

County

MISSOURI

Ever Disciplined

LastModifiedDate

07/28/2005