PEGGY KAY DISTAD Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006047

License Status

NOT RENEWED

Business

First Name

PEGGY

Middle

KAY

Last Name

DISTAD

Business Name

PEGGY KAY DISTAD

Original Issue Date

03/16/2001

Effective Date

03/23/2004

Expiration Date

12/31/2005

City

SOUTH MILWAUKEE

State

Zip

53172

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/16/2006