JENNA S MANGOLD Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006436

License Status

NOT RENEWED

Business

First Name

JENNA

Middle

Last Name

MANGOLD

Business Name

JENNA S MANGOLD

Original Issue Date

03/27/2002

Effective Date

12/09/2013

Expiration Date

12/31/2015

City

EVANSVILLE

State

Zip

53536

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/08/2016