RANDY THOMAS DAHL Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005643

License Status

NOT RENEWED

Business

First Name

RANDY

Middle

THOMAS

Last Name

DAHL

Business Name

RANDY THOMAS DAHL

Original Issue Date

12/17/1999

Effective Date

01/27/2004

Expiration Date

12/31/2003

City

BROOKFIELD

State

Zip

53005

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/11/2005