GABRIELLE NICOLE GOFORTH Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056011541

License Status

NOT RENEWED

Business

First Name

GABRIELLE

Middle

NICOLE

Last Name

GOFORTH

Business Name

GABRIELLE NICOLE GOFORTH

Original Issue Date

05/19/2016

Effective Date

01/01/2022

Expiration Date

12/31/2023

City

COLUMBIA

State

Zip

29229

Ever Disciplined

LastModifiedDate

03/28/2024