KRISTA MARIE LARSEN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006421

License Status

NOT RENEWED

Business

First Name

KRISTA

Middle

MARIE

Last Name

LARSEN

Business Name

KRISTA MARIE LARSEN

Original Issue Date

03/05/2002

Effective Date

11/06/2003

Expiration Date

12/31/2005

City

SALT LAKE CITY

State

Zip

84108

County

DEKALB

Ever Disciplined

LastModifiedDate

02/16/2006