SHEILA A PROVINE Speech-Language Pathologist License verification

Business Entity

INACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146000563

License Status

INACTIVE

Business

First Name

SHEILA A

Last Name

PROVINE

Business Name

SHEILA A PROVINE

Original Issue Date

05/12/1989

Effective Date

10/06/2003

Expiration Date

10/31/2003

City

ADAIR

State

Zip

61411

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

09/11/2005