AMY S PROVOST Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

SPEECH-LANGUAGE PATHOLOGY ASSISTANT

License Number

217000102

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

PROVOST

Business Name

AMY S PROVOST

Original Issue Date

04/20/2005

Effective Date

11/01/2005

Expiration Date

10/31/2007

City

MANTENO

State

Zip

60950

County

KANKAKEE

Ever Disciplined

LastModifiedDate

12/05/2007