MALLORY MARIAN PARK Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146028416

License Status

ACTIVE

Business

First Name

MALLORY

Middle

MARIAN

Last Name

PARK

Business Name

MALLORY MARIAN PARK

Original Issue Date

07/10/2025

Effective Date

11/01/2025

Expiration Date

10/31/2027

City

ATKINSON

State

Zip

61235

County

HENRY

Ever Disciplined

LastModifiedDate

11/04/2025