IAN SAMSON STEVENS Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056010403

License Status

NOT RENEWED

Business

First Name

IAN

Middle

SAMSON

Last Name

STEVENS

Business Name

IAN SAMSON STEVENS

Original Issue Date

12/10/2013

Effective Date

12/15/2015

Expiration Date

12/31/2017

City

VERONA

State

Zip

53593

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/10/2018