MARY C GAVIN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056001503

License Status

NOT RENEWED

Business

First Name

MARY C

Last Name

GAVIN

Business Name

MARY C GAVIN

Original Issue Date

03/12/1986

Effective Date

01/06/2004

Expiration Date

12/31/2005

City

FONTANA

State

Zip

53125

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/16/2006