ELIZABETH ANN ELLIS Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056010167

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

ANN

Last Name

ELLIS

Business Name

ELIZABETH ANN ELLIS

Original Issue Date

05/13/2013

Effective Date

10/06/2017

Expiration Date

12/31/2019

City

COTTAGE GROVE

State

Zip

53527

County

WISCONSIN

Ever Disciplined

LastModifiedDate

03/05/2020