JACOB DONIVAN PELOQUIN Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056008205

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

DONIVAN

Last Name

PELOQUIN

Business Name

JACOB DONIVAN PELOQUIN

Original Issue Date

11/08/2007

Effective Date

12/21/2009

Expiration Date

12/31/2011

City

LA CROSSE

State

Zip

54602

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/08/2012