RUSSELL WAYNE PICKETT Speech-Language Pathologist License verification

Business Entity

INACTIVE

License Type

Speech-Language Pathologist

Description

LICENSED AUDIOLOGIST

License Number

147001094

License Status

INACTIVE

Business

First Name

RUSSELL

Middle

WAYNE

Last Name

PICKETT

Business Name

RUSSELL WAYNE PICKETT

Original Issue Date

06/16/2003

Effective Date

11/19/2003

Expiration Date

10/31/2005

City

KIRKWOOD

State

Zip

63122

Ever Disciplined

LastModifiedDate

09/09/2005