KIM ILEANA JACOBS Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006729

License Status

NOT RENEWED

Business

First Name

KIM

Middle

ILEANA

Last Name

JACOBS

Business Name

KIM ILEANA JACOBS

Original Issue Date

11/13/2002

Effective Date

10/25/2005

Expiration Date

12/31/2007

City

EAST TROY

State

Zip

53120

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/15/2008