Indiana
Professional Licensing Agency
Jan Ethan Banquicio
Occupational Therapist
License number
31004083A
Date granted
09/20/2004
Date expires
12/31/2014
Class
Occupational Therapist
Status
Active
Address
Kokomo IN 46902
indianalicensing.org
ID 8279981
LAST UPDATED 2026-06-15 20:48:13 UTC
LAST UPDATED 2026-06-15 20:48:13 UTC
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