DIANE F COSTULAS Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056011620

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

COSTULAS

Business Name

DIANE F COSTULAS

Original Issue Date

08/17/2016

Effective Date

08/17/2016

Expiration Date

12/31/2017

City

BLOOMSBURG

State

Zip

17815

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

04/10/2018