STEPHANIE ANN MARIE DIENER Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056004394

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

ANN MARIE

Last Name

DIENER

Business Name

STEPHANIE ANN MARIE DIENER

Original Issue Date

05/03/1997

Effective Date

12/19/2011

Expiration Date

12/31/2013

City

LISBON

State

Zip

53089

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/19/2014