HEIDI C BOURG Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

LICENSED AUDIOLOGIST

License Number

147001002

License Status

NOT RENEWED

Business

First Name

HEIDI

Middle

Last Name

BOURG

Business Name

HEIDI C BOURG

Original Issue Date

08/31/2001

Effective Date

12/10/2003

Expiration Date

10/31/2003

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/11/2005