JENNIFER NICOLE EVANS Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056011634

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

NICOLE

Last Name

EVANS

Business Name

JENNIFER NICOLE EVANS

Original Issue Date

08/25/2016

Effective Date

08/25/2016

Expiration Date

12/31/2017

City

PLEASANT PRAIRIE

State

Zip

53158

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/10/2018