BASHA ONTIVEROS Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146007682

License Status

NOT RENEWED

Business

First Name

BASHA

Last Name

ONTIVEROS

Business Name

BASHA ONTIVEROS

Original Issue Date

02/03/2004

Effective Date

01/19/2022

Expiration Date

10/31/2023

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

03/28/2024