KIM ILEANA JACOBS Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057001039

License Status

NOT RENEWED

Business

First Name

KIM

Middle

ILEANA

Last Name

JACOBS

Business Name

KIM ILEANA JACOBS

Original Issue Date

08/26/1994

Expiration Date

12/31/1995

City

EAST TROY

State

Zip

53120

County

WISCONSIN

Ever Disciplined

LastModifiedDate

07/28/2005