TARA L SOUTHWICK Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

LICENSED AUDIOLOGIST

License Number

147001375

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

SOUTHWICK

Business Name

TARA L SOUTHWICK

Original Issue Date

12/27/2010

Effective Date

10/28/2019

Expiration Date

01/31/2022

City

ROCA

State

Zip

68430

Ever Disciplined

LastModifiedDate

05/18/2022