ALITA JOLANDE DORN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056004270

License Status

NOT RENEWED

Business

First Name

ALITA JOLANDE

Last Name

DORN

Business Name

ALITA JOLANDE DORN

Original Issue Date

10/09/1996

Effective Date

12/21/2011

Expiration Date

12/31/2013

City

JANESVILLE

State

Zip

53545

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/19/2014