JENNIFER SUSANNE STORK Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146006941

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

SUSANNE

Last Name

STORK

Business Name

JENNIFER SUSANNE STORK

Original Issue Date

02/19/2002

Effective Date

11/02/2015

Expiration Date

10/31/2017

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

01/04/2018