The holder whose full name is Jacobs, Bonny Louise,come from Fort Wayne IN,hold the Temporary Occ Therapist Permit license(NO.99006716A) which status is Superceded.
Name | Jacobs, Bonny Louise |
---|---|
License Number | 99006716A |
License Type | Temporary Occ Therapist Permit |
License Status | Superceded |
City | Fort Wayne |
State | IN |