AMY ELIZABETH PORTS Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006276

License Status

INACTIVE

Business

First Name

AMY

Middle

ELIZABETH

Last Name

PORTS

Business Name

AMY ELIZABETH PORTS

Original Issue Date

09/24/2001

Effective Date

11/24/2003

Expiration Date

12/31/2005

City

MIDLAND

State

Zip

79707

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/15/2005