SALLY F ETZENBACH Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

LICENSED SPEECH LANGUAGE PATHOLOGY TEMPORARY

License Number

242003693

License Status

NOT RENEWED

Business

First Name

SALLY

Middle

Last Name

ETZENBACH

Business Name

SALLY F ETZENBACH

Original Issue Date

08/10/2015

Effective Date

08/10/2015

Expiration Date

08/10/2016

City

GRANVILLE

State

Zip

61326

County

PUTNAM

Ever Disciplined

LastModifiedDate

03/09/2017