THERESE JOLO BANTASAN Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006957

License Status

INACTIVE

Business

First Name

THERESE

Middle

JOLO

Last Name

BANTASAN

Business Name

THERESE JOLO BANTASAN

Original Issue Date

09/02/2003

Effective Date

01/04/2016

Expiration Date

12/31/2017

City

SPRINGFIELD

State

Zip

22153

County

VIRGINIA

Ever Disciplined

LastModifiedDate

10/06/2017