ROBERTA L BENNER Occupational Therapist License verification

Business Entity

INACTIVE

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPY ASSISTANT

License Number

057003688

License Status

INACTIVE

Business

First Name

ROBERTA

Middle

Last Name

BENNER

Business Name

ROBERTA L BENNER

Original Issue Date

10/30/2012

Effective Date

10/30/2012

Expiration Date

12/31/2013

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/04/2013