BENNET J PETERSEN Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056013645

License Status

INACTIVE

Business

First Name

BENNET

Middle

Last Name

PETERSEN

Business Name

BENNET J PETERSEN

Original Issue Date

06/02/2020

Effective Date

06/02/2020

Expiration Date

12/31/2021

City

MILWAUKEE

State

Zip

53220

Ever Disciplined

LastModifiedDate

11/20/2021