MARY THERESA VANDIVER Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146006321

License Status

ACTIVE

Business

First Name

MARY

Middle

THERESA

Last Name

VANDIVER

Business Name

MARY THERESA VANDIVER

Original Issue Date

06/15/2000

Effective Date

10/31/2025

Expiration Date

10/31/2027

City

HEYWORTH

State

Zip

61745

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/31/2025