ANNE J WIERSGALLA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056009955

License Status

NOT RENEWED

Business

First Name

ANNE

Middle

Last Name

WIERSGALLA

Business Name

ANNE J WIERSGALLA

Original Issue Date

11/05/2012

Effective Date

12/14/2015

Expiration Date

12/31/2017

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/10/2018