MOLLY MARIE BASTIDA Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

LICENSED AUDIOLOGIST

License Number

147002055

License Status

ACTIVE

Business

First Name

MOLLY

Middle

MARIE

Last Name

BASTIDA

Business Name

MOLLY MARIE BASTIDA

Original Issue Date

05/14/2025

Effective Date

10/17/2025

Expiration Date

10/31/2027

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2025