LESLEY LORAINE BLUM Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056008075

License Status

NOT RENEWED

Business

First Name

LESLEY

Middle

LORAINE

Last Name

BLUM

Business Name

LESLEY LORAINE BLUM

Original Issue Date

06/26/2007

Effective Date

10/10/2007

Expiration Date

12/31/2009

City

ELKHORN

State

Zip

53121

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/04/2010